CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Saint Joseph Regional Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $974
  • Cash Discount Price: $3,763
  • vs. Medicare Baseline: 2.73x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without 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 $3,763. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.73x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$3,763

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
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $3,763 (1056%)
Insurance Median: $974 (273%)
Cash: $3,763 (1056% of Medicare)
Ins. Median: $974 (273% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 273% of the Medicare baseline (a markup of 173%). 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 $84 - $1,303 24%
UnitedHealthcare $105 - $1,876 29%
Geha $112 - $1,056 31%
Healthscope $112 - $1,056 31%
Student Insurance Cma $112 - $1,056 31%
Aetna $191 - $3,763 54%
Medicaid / KanCare $191 - $756 54%
Medicare (plans) $369 - $376 104%
Meridian Complete $369 104%
Pace-Trinity Health $369 104%
County Coroner $384 108%
Provider Partners Health Plan Of Indiana $406 114%
Auxiant $554 - $4,805 155%
Physicians Health Plan Northern Indiana Health Insurance $554 - $1,115 155%
St Joseph County Hlth Dpt $554 155%
Caresource $572 160%
Siho Insurance Services $591 166%
Key Benefit Administrator $664 - $3,602 186%
Allied Benefit Systems $701 - $3,763 197%
Managed Health Services - Indiana $756 212%
Mdwise $756 212%
Custom Design Benefits $794 223%
Asr Health Benefits $974 - $3,763 273%
Christian Brother Services $974 - $3,763 273%
Employee Benefit Management $974 - $3,763 273%
Medical Mutual $974 - $3,763 273%
Meritain $974 - $3,763 273%
Preferred One $974 - $3,763 273%
Rural Carrier Health Benefit Plan $974 - $3,763 273%
Webtpa $974 - $3,763 273%
Blue Benefit Administrators Of Massachusetts $1,303 366%
Blue Care Network $1,303 366%
Blue Distinction Transplant $1,303 366%
Blue Shield - Ca $1,303 366%
Blue Shield - Id (Regence) $1,303 366%
Blue Shield - Ny Highmark Northeastern $1,303 366%
Blue Shield - Ny Highmark Western $1,303 366%
Blue Shield - Pa (Highmark) $1,303 366%
Blue Shield - Wa (Regence) $1,303 366%
Hospice Of Marshall County $1,505 422%
Hospice Of St Joseph County $1,505 422%
Plain Church Group $1,563 439%
Notre Dame Athletic Association $3,184 893%
Wc Notre Dame $3,184 893%
Luminare Health (Detroit) $3,300 - $3,473 926%
Encore Health $3,431 - $3,602 963%
Ameriben $3,473 974%
Indiana Criminal Justice Inst $3,602 1011%
Western & Southern Financial Group $3,602 1011%
Cigna $3,705 1039%
Group Administrators $3,705 1039%
Health Partners $3,705 1039%
Mvp $3,705 1039%
Prairie States $3,705 1039%
Priority Health $3,705 1039%
Professional Benefit Administrators $3,705 1039%
Sagamore Health Network $3,705 - $4,284 1039%
Sisco Benefits $3,705 1039%
Unified Group Services $3,705 1039%
Goshen Preferred Network $4,458 - $4,979 1251%
Christian Brothers Holy Cross $4,631 1299%
Signature Care $4,631 1299%
Bankers Life Casualty $5,789 1624%
Bureau Of Disability $5,789 1624%
Wc Align Network $5,789 1624%

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