CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Saint Joseph Regional Medical Center

Billing Code: 99203 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$86
about 0.7× the $118 Medicare rate · typically $60–$128
modeled estimate · not a bill or quote
What this hospital charges insurers
$108
Above the fair price
about $22 over the fair price · 0.9× Medicare
Medicare pays $118 Fair price $86 This hospital $108 Cash price $242 Hospital's list price $242

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

Highest price of the 9 IN hospitals we have prices for — worth calling around.

Cheapest $45 Priciest $108

Black dot = this hospital, among the 9 IN hospitals with a price for this procedure. Full list below.

A fair price for a New patient office visit (30-44 min) is about $86 (about 0.7× the $118 Medicare rate). Saint Joseph Regional Medical Center charges insurers about $108, or about $242 in cash — above the fair price. Located in Mishawaka, IN.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $86. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $92 - $156 78%
Blue Cross Blue Shieldmajor $102 - $129 87%
Aetnamajor $102 - $145 87%
Cignamajor $102 - $164 87%
Humanamajor $102 - $108 87%
Kaiser Permanentemajor $129 110%
Ambetter (Centene) $102 87%
CareSource $144 122%
Clover Health $108 92%
GEHA $156 133%
Health Net $102 - $175 87%
HealthPartners $102 87%
Meridian $102 - $108 87%
Molina $102 87%
Paramount $102 87%
Presbyterian $102 - $108 87%
Tufts Health Plan $102 87%
WellMed $108 92%
WellSense $102 87%
+ 347 smaller / regional plans $102 - $246
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 10 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

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