CMS Price Transparency Data

X-ray, foot

Facility: Saint Joseph Regional Medical Center

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $324
  • Cash Discount Price: $405
  • vs. Medicare Baseline: 3.64x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Saint Joseph Regional Medical Center is $324. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $405. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.64x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$405

Average discount available for prompt cash payment at this facility.

Insurance Median
$324

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: $405 (456%)
Insurance Median: $324 (364%)
Cash: $405 (456% of Medicare)
Ins. Median: $324 (364% 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 364% of the Medicare baseline (a markup of 264%). 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 - $486 54%
Blue Cross Blue Shield $48 - $325 54%
Medicaid / KanCare $48 - $63 54%
UnitedHealthcare $48 - $476 54%
Managed Health Services - Indiana $63 71%
Mdwise $63 71%
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 - $194 146%
Hospice Of St Joseph County $130 - $194 146%
Plain Church Group $135 - $202 152%
Auxiant $138 - $620 155%
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 - $465 187%
Allied Benefit Systems $175 - $486 197%
Custom Design Benefits $198 223%
Notre Dame Athletic Association $274 - $411 308%
Wc Notre Dame $274 - $411 308%
Luminare Health (Detroit) $284 - $448 319%
Encore Health $296 - $465 333%
Ameriben $299 - $448 336%
Indiana Criminal Justice Inst $310 - $465 349%
Western & Southern Financial Group $310 - $465 349%
Geha $318 - $476 358%
Healthscope $318 - $476 358%
Student Insurance Cma $318 - $476 358%
Cigna $319 - $478 359%
Group Administrators $319 - $478 359%
Health Partners $319 - $478 359%
Mvp $319 - $478 359%
Prairie States $319 - $478 359%
Priority Health $319 - $478 359%
Professional Benefit Administrators $319 - $478 359%
Sagamore Health Network $319 - $553 359%
Sisco Benefits $319 - $478 359%
Unified Group Services $319 - $478 359%
Asr Health Benefits $324 - $486 364%
Christian Brother Services $324 - $486 364%
Employee Benefit Management $324 - $486 364%
Medical Mutual $324 - $486 364%
Meritain $324 - $486 364%
Preferred One $324 - $486 364%
Rural Carrier Health Benefit Plan $324 - $486 364%
Webtpa $324 - $486 364%
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%
Goshen Preferred Network $384 - $642 432%
Christian Brothers Holy Cross $399 - $598 449%
Signature Care $399 - $598 449%
Bankers Life Casualty $499 - $747 561%
Bureau Of Disability $499 - $747 561%
Wc Align Network $499 - $747 561%

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