CMS Price Transparency Data

CT scan, pelvis

Facility: Saint Joseph Regional Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $780
  • Cash Discount Price: $1,949
  • vs. Medicare Baseline: 7.30x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Saint Joseph Regional Medical Center is $780. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,949. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.30x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$1,949

Average discount available for prompt cash payment at this facility.

Insurance Median
$780

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $1,949 (1825%)
Insurance Median: $780 (730%)
Cash: $1,949 (1825% of Medicare)
Ins. Median: $780 (730% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 730% of the Medicare baseline (a markup of 630%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $57 - $1,949 53%
Blue Cross Blue Shield $57 - $391 53%
Medicaid / KanCare $57 - $262 53%
UnitedHealthcare $57 - $878 53%
Medicare (plans) $111 - $113 104%
Meridian Complete $111 104%
Pace-Trinity Health $111 104%
County Coroner $115 108%
Provider Partners Health Plan Of Indiana $122 114%
Auxiant $166 - $2,489 155%
Physicians Health Plan Northern Indiana Health Insurance $166 - $334 155%
St Joseph County Hlth Dpt $166 155%
Caresource $171 160%
Siho Insurance Services $177 166%
Key Benefit Administrator $199 - $1,866 186%
Allied Benefit Systems $210 - $1,949 197%
Custom Design Benefits $238 223%
Managed Health Services - Indiana $262 245%
Mdwise $262 245%
Blue Benefit Administrators Of Massachusetts $391 366%
Blue Care Network $391 366%
Blue Distinction Transplant $391 366%
Blue Shield - Ca $391 366%
Blue Shield - Id (Regence) $391 366%
Blue Shield - Ny Highmark Northeastern $391 366%
Blue Shield - Ny Highmark Western $391 366%
Blue Shield - Pa (Highmark) $391 366%
Blue Shield - Wa (Regence) $391 366%
Hospice Of Marshall County $780 730%
Hospice Of St Joseph County $780 730%
Plain Church Group $810 758%
Geha $878 822%
Healthscope $878 822%
Student Insurance Cma $878 822%
Notre Dame Athletic Association $1,649 1544%
Wc Notre Dame $1,649 1544%
Luminare Health (Detroit) $1,709 - $1,799 1600%
Encore Health $1,777 - $1,866 1664%
Ameriben $1,799 1684%
Indiana Criminal Justice Inst $1,866 1747%
Western & Southern Financial Group $1,866 1747%
Cigna $1,919 1797%
Group Administrators $1,919 1797%
Health Partners $1,919 1797%
Mvp $1,919 1797%
Prairie States $1,919 1797%
Priority Health $1,919 1797%
Professional Benefit Administrators $1,919 1797%
Sagamore Health Network $1,919 - $2,219 1797%
Sisco Benefits $1,919 1797%
Unified Group Services $1,919 1797%
Asr Health Benefits $1,949 1825%
Christian Brother Services $1,949 1825%
Employee Benefit Management $1,949 1825%
Medical Mutual $1,949 1825%
Meritain $1,949 1825%
Preferred One $1,949 1825%
Rural Carrier Health Benefit Plan $1,949 1825%
Webtpa $1,949 1825%
Goshen Preferred Network $2,309 - $2,579 2162%
Christian Brothers Holy Cross $2,399 2246%
Signature Care $2,399 2246%
Bankers Life Casualty $2,999 2808%
Bureau Of Disability $2,999 2808%
Wc Align Network $2,999 2808%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals