CMS Price Transparency Data

X-ray, ankle

Facility: Saint Joseph Regional Medical Center

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73610
  • Insurance Median: $321
  • Cash Discount Price: $488
  • vs. Medicare Baseline: 3.61x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at Saint Joseph Regional Medical Center is $321. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $488. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.61x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$488

Average discount available for prompt cash payment at this facility.

Insurance Median
$321

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $488 (549%)
Insurance Median: $321 (361%)
Cash: $488 (549% of Medicare)
Ins. Median: $321 (361% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 361% of the Medicare baseline (a markup of 261%). 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 $48 - $488 54%
Blue Cross Blue Shield $48 - $325 54%
Medicaid / KanCare $48 - $68 54%
UnitedHealthcare $48 - $478 54%
Managed Health Services - Indiana $68 76%
Mdwise $68 76%
Medicare (plans) $92 - $94 103%
Meridian Complete $92 103%
Pace-Trinity Health $92 103%
County Coroner $96 108%
Provider Partners Health Plan Of Indiana $101 114%
Hospice Of Marshall County $130 - $195 146%
Hospice Of St Joseph County $130 - $195 146%
Plain Church Group $135 - $203 152%
Auxiant $138 - $623 155%
Physicians Health Plan Northern Indiana Health Insurance $138 - $278 155%
St Joseph County Hlth Dpt $138 155%
Caresource $143 161%
Siho Insurance Services $147 165%
Key Benefit Administrator $166 - $467 187%
Allied Benefit Systems $175 - $488 197%
Custom Design Benefits $198 223%
Notre Dame Athletic Association $276 - $413 310%
Wc Notre Dame $276 - $413 310%
Luminare Health (Detroit) $286 - $451 322%
Encore Health $297 - $467 334%
Ameriben $301 - $451 339%
Indiana Criminal Justice Inst $312 - $467 351%
Western & Southern Financial Group $312 - $467 351%
Geha $319 - $478 359%
Healthscope $319 - $478 359%
Student Insurance Cma $319 - $478 359%
Cigna $321 - $481 361%
Group Administrators $321 - $481 361%
Health Partners $321 - $481 361%
Mvp $321 - $481 361%
Prairie States $321 - $481 361%
Priority Health $321 - $481 361%
Professional Benefit Administrators $321 - $481 361%
Sagamore Health Network $321 - $556 361%
Sisco Benefits $321 - $481 361%
Unified Group Services $321 - $481 361%
Blue Benefit Administrators Of Massachusetts $325 366%
Blue Care Network $325 366%
Blue Distinction Transplant $325 366%
Blue Shield - Ca $325 366%
Blue Shield - Id (Regence) $325 366%
Blue Shield - Ny Highmark Northeastern $325 366%
Blue Shield - Ny Highmark Western $325 366%
Blue Shield - Pa (Highmark) $325 366%
Blue Shield - Wa (Regence) $325 366%
Asr Health Benefits $326 - $488 367%
Christian Brother Services $326 - $488 367%
Employee Benefit Management $326 - $488 367%
Medical Mutual $326 - $488 367%
Meritain $326 - $488 367%
Preferred One $326 - $488 367%
Rural Carrier Health Benefit Plan $326 - $488 367%
Webtpa $326 - $488 367%
Goshen Preferred Network $386 - $646 434%
Christian Brothers Holy Cross $401 - $601 451%
Signature Care $401 - $601 451%
Bankers Life Casualty $501 - $751 563%
Bureau Of Disability $501 - $751 563%
Wc Align Network $501 - $751 563%

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