CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Saint Joseph Regional Medical Center

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$81
about 0.6× the $136 Medicare rate · typically $60–$98
modeled estimate · not a bill or quote
What this hospital charges insurers
$100
Above the fair price
about $19 over the fair price · 0.7× Medicare
Medicare pays $136 Fair price $81 This hospital $100 Hospital's list price $159

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 $47 Priciest $100

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

A fair price for a Office visit, established patient (30-39 min) is about $81 (about 0.6× the $136 Medicare rate). Saint Joseph Regional Medical Center charges insurers about $100 — 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 $81. 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 $14 - $159 10%
Blue Cross Blue Shieldmajor $14 - $891 10%
Aetnamajor $14 - $168 10%
Cignamajor $14 - $189 10%
Humanamajor $14 - $126 10%
Kaiser Permanentemajor $20 - $142 15%
Ambetter (Centene) $14 - $118 10%
CareSource $17 - $391 13%
Clover Health $20 - $126 15%
GEHA $19 - $158 14%
Health Net $14 - $189 10%
HealthPartners $14 - $118 10%
Meridian $14 - $126 10%
Molina $14 - $118 10%
Paramount $14 - $118 10%
Presbyterian $14 - $126 10%
Tufts Health Plan $14 - $118 10%
WellMed $20 - $126 15%
WellSense $14 - $118 10%
+ 348 smaller / regional plans $14 - $891
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