CMS Price Transparency Data

Culture, bacterial

Facility: Saint Joseph Regional Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $56
  • Cash Discount Price: $226
  • vs. Medicare Baseline: 6.50x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Saint Joseph Regional Medical Center is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $226. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 6.50x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$226

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.62

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.62 (100%)
Cash / Self-Pay: $226 (2622%)
Insurance Median: $56 (650%)
Cash: $226 (2622% of Medicare)
Ins. Median: $56 (650% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.62 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 650% of the Medicare baseline (a markup of 550%). 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 $5 - $2,708 58%
Blue Cross Blue Shield $5 - $6,169 58%
Medicaid / KanCare $5 - $4,316 58%
UnitedHealthcare $5 - $4,316 58%
County Coroner $9 - $1,817 104%
Managed Health Services - Indiana $9 - $4,316 104%
Mdwise $9 - $4,316 104%
Medicare (plans) $9 - $1,782 104%
Meridian Complete $9 - $1,747 104%
Pace-Trinity Health $9 - $1,747 104%
Provider Partners Health Plan Of Indiana $9 - $1,922 104%
Auxiant $13 - $3,757 151%
Caresource $13 - $2,708 151%
Physicians Health Plan Northern Indiana Health Insurance $13 - $5,277 151%
St Joseph County Hlth Dpt $13 - $2,621 151%
Siho Insurance Services $14 - $2,796 162%
Hospice Of Marshall County $15 - $90 174%
Hospice Of St Joseph County $15 - $90 174%
Plain Church Group $15 - $94 174%
Allied Benefit Systems $16 - $3,320 186%
Key Benefit Administrator $16 - $3,757 186%
Blue Benefit Administrators Of Massachusetts $17 - $6,169 197%
Blue Care Network $17 - $6,169 197%
Blue Distinction Transplant $17 - $6,169 197%
Blue Shield - Ca $17 - $6,169 197%
Blue Shield - Id (Regence) $17 - $6,169 197%
Blue Shield - Ny Highmark Northeastern $17 - $6,169 197%
Blue Shield - Ny Highmark Western $17 - $6,169 197%
Blue Shield - Pa (Highmark) $17 - $6,169 197%
Blue Shield - Wa (Regence) $17 - $6,169 197%
Custom Design Benefits $19 - $3,757 220%
Asr Health Benefits $27 - $169 313%
Christian Brother Services $27 - $169 313%
Employee Benefit Management $27 - $169 313%
Medical Mutual $27 - $169 313%
Meritain $27 - $169 313%
Preferred One $27 - $169 313%
Rural Carrier Health Benefit Plan $27 - $169 313%
Webtpa $27 - $169 313%
Notre Dame Athletic Association $31 - $191 360%
Wc Notre Dame $31 - $191 360%
Indiana Breast Cervical Cancer $32 371%
Luminare Health (Detroit) $32 - $208 371%
Encore Health $33 - $216 383%
Ameriben $34 - $208 394%
Indiana Criminal Justice Inst $35 - $216 406%
Western & Southern Financial Group $35 - $216 406%
Cigna $36 - $222 418%
Geha $36 - $221 418%
Group Administrators $36 - $222 418%
Health Partners $36 - $222 418%
Healthscope $36 - $221 418%
Mvp $36 - $222 418%
Prairie States $36 - $222 418%
Priority Health $36 - $222 418%
Professional Benefit Administrators $36 - $222 418%
Sagamore Health Network $36 - $257 418%
Sisco Benefits $36 - $222 418%
Student Insurance Cma $36 - $221 418%
Unified Group Services $36 - $222 418%
Goshen Preferred Network $43 - $298 499%
Christian Brothers Holy Cross $45 - $278 522%
Signature Care $45 - $278 522%
Bankers Life Casualty $56 - $347 650%
Bureau Of Disability $56 - $347 650%
Wc Align Network $56 - $347 650%

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