CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Saint Joseph Regional Medical Center

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76700
  • Insurance Median: $414
  • Cash Discount Price: $1,016
  • vs. Medicare Baseline: 3.88x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Saint Joseph Regional Medical Center is $414. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,016. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.88x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$1,016

Average discount available for prompt cash payment at this facility.

Insurance Median
$414

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $1,016 (951%)
Insurance Median: $414 (388%)
Cash: $1,016 (951% of Medicare)
Ins. Median: $414 (388% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 388% of the Medicare baseline (a markup of 288%). 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 $57 - $1,016 53%
Blue Cross Blue Shield $57 - $391 53%
Medicaid / KanCare $57 - $274 53%
UnitedHealthcare $57 - $996 53%
Medicare (plans) $111 - $113 104%
Meridian Complete $111 104%
Pace-Trinity Health $111 104%
County Coroner $115 108%
Provider Partners Health Plan Of Indiana $122 114%
Auxiant $166 - $1,297 155%
Physicians Health Plan Northern Indiana Health Insurance $166 - $334 155%
St Joseph County Hlth Dpt $166 155%
Caresource $171 160%
Siho Insurance Services $177 166%
Key Benefit Administrator $199 - $972 186%
Allied Benefit Systems $210 - $1,016 197%
Custom Design Benefits $238 223%
Managed Health Services - Indiana $274 257%
Mdwise $274 257%
Blue Benefit Administrators Of Massachusetts $391 366%
Blue Care Network $391 366%
Blue Distinction Transplant $391 366%
Blue Shield - Ca $391 366%
Blue Shield - Id (Regence) $391 366%
Blue Shield - Ny Highmark Northeastern $391 366%
Blue Shield - Ny Highmark Western $391 366%
Blue Shield - Pa (Highmark) $391 366%
Blue Shield - Wa (Regence) $391 366%
Hospice Of Marshall County $406 380%
Hospice Of St Joseph County $406 380%
Plain Church Group $422 395%
Notre Dame Athletic Association $860 805%
Wc Notre Dame $860 805%
Luminare Health (Detroit) $891 - $938 834%
Encore Health $926 - $972 867%
Ameriben $938 878%
Indiana Criminal Justice Inst $972 910%
Western & Southern Financial Group $972 910%
Geha $996 932%
Healthscope $996 932%
Student Insurance Cma $996 932%
Cigna $1,000 936%
Group Administrators $1,000 936%
Health Partners $1,000 936%
Mvp $1,000 936%
Prairie States $1,000 936%
Priority Health $1,000 936%
Professional Benefit Administrators $1,000 936%
Sagamore Health Network $1,000 - $1,157 936%
Sisco Benefits $1,000 936%
Unified Group Services $1,000 936%
Asr Health Benefits $1,016 951%
Christian Brother Services $1,016 951%
Employee Benefit Management $1,016 951%
Medical Mutual $1,016 951%
Meritain $1,016 951%
Preferred One $1,016 951%
Rural Carrier Health Benefit Plan $1,016 951%
Webtpa $1,016 951%
Goshen Preferred Network $1,204 - $1,344 1127%
Christian Brothers Holy Cross $1,250 1170%
Signature Care $1,250 1170%
Bankers Life Casualty $1,563 1463%
Bureau Of Disability $1,563 1463%
Wc Align Network $1,563 1463%

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