CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Saint Joseph Regional Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $974
  • Cash Discount Price: $2,678
  • vs. Medicare Baseline: 4.00x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Saint Joseph Regional Medical Center is $974. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,678. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.00x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$2,678

Average discount available for prompt cash payment at this facility.

Insurance Median
$974

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $2,678 (1099%)
Insurance Median: $974 (400%)
Cash: $2,678 (1099% of Medicare)
Ins. Median: $974 (400% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 400% of the Medicare baseline (a markup of 300%). 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
Blue Cross Blue Shield $116 - $891 48%
Aetna $131 - $2,678 54%
Medicaid / KanCare $131 - $464 54%
UnitedHealthcare $131 - $1,335 54%
Geha $209 - $1,056 86%
Healthscope $209 - $1,056 86%
Student Insurance Cma $209 - $1,056 86%
Medicare (plans) $252 - $257 103%
Meridian Complete $252 103%
Pace-Trinity Health $252 103%
County Coroner $263 108%
Provider Partners Health Plan Of Indiana $278 114%
Auxiant $379 - $3,420 155%
Physicians Health Plan Northern Indiana Health Insurance $379 - $762 155%
St Joseph County Hlth Dpt $379 155%
Caresource $391 160%
Siho Insurance Services $404 166%
Key Benefit Administrator $454 - $2,563 186%
Managed Health Services - Indiana $464 190%
Mdwise $464 190%
Allied Benefit Systems $480 - $2,678 197%
Custom Design Benefits $543 223%
Blue Benefit Administrators Of Massachusetts $891 366%
Blue Care Network $891 366%
Blue Distinction Transplant $891 366%
Blue Shield - Ca $891 366%
Blue Shield - Id (Regence) $891 366%
Blue Shield - Ny Highmark Northeastern $891 366%
Blue Shield - Ny Highmark Western $891 366%
Blue Shield - Pa (Highmark) $891 366%
Blue Shield - Wa (Regence) $891 366%
Asr Health Benefits $974 - $2,678 400%
Christian Brother Services $974 - $2,678 400%
Employee Benefit Management $974 - $2,678 400%
Medical Mutual $974 - $2,678 400%
Meritain $974 - $2,678 400%
Preferred One $974 - $2,678 400%
Rural Carrier Health Benefit Plan $974 - $2,678 400%
Webtpa $974 - $2,678 400%
Hospice Of Marshall County $1,071 439%
Hospice Of St Joseph County $1,071 439%
Plain Church Group $1,112 456%
Notre Dame Athletic Association $2,266 930%
Wc Notre Dame $2,266 930%
Luminare Health (Detroit) $2,348 - $2,472 963%
Encore Health $2,442 - $2,563 1002%
Ameriben $2,472 1014%
Indiana Criminal Justice Inst $2,563 1051%
Western & Southern Financial Group $2,563 1051%
Cigna $2,637 1082%
Group Administrators $2,637 1082%
Health Partners $2,637 1082%
Mvp $2,637 1082%
Prairie States $2,637 1082%
Priority Health $2,637 1082%
Professional Benefit Administrators $2,637 1082%
Sagamore Health Network $2,637 - $3,049 1082%
Sisco Benefits $2,637 1082%
Unified Group Services $2,637 1082%
Goshen Preferred Network $3,172 - $3,543 1301%
Christian Brothers Holy Cross $3,296 1352%
Signature Care $3,296 1352%
Bankers Life Casualty $4,120 1690%
Bureau Of Disability $4,120 1690%
Wc Align Network $4,120 1690%

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