CMS Price Transparency Data

X-ray, hand

Facility: Saint Joseph Regional Medical Center

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73130
  • Insurance Median: $323
  • Cash Discount Price: $410
  • vs. Medicare Baseline: 3.63x Medicare
The contracted insurance negotiated median rate for a X-ray, hand at Saint Joseph Regional Medical Center is $323. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $410. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.63x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$410

Average discount available for prompt cash payment at this facility.

Insurance Median
$323

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: $410 (461%)
Insurance Median: $323 (363%)
Cash: $410 (461% of Medicare)
Ins. Median: $323 (363% 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 363% of the Medicare baseline (a markup of 263%). 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 - $492 54%
Blue Cross Blue Shield $48 - $325 54%
Medicaid / KanCare $48 - $66 54%
UnitedHealthcare $48 - $482 54%
Managed Health Services - Indiana $66 74%
Mdwise $66 74%
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 $131 - $197 147%
Hospice Of St Joseph County $131 - $197 147%
Plain Church Group $136 - $204 153%
Auxiant $138 - $628 155%
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 - $471 187%
Allied Benefit Systems $175 - $492 197%
Custom Design Benefits $198 223%
Notre Dame Athletic Association $278 - $416 313%
Wc Notre Dame $278 - $416 313%
Luminare Health (Detroit) $288 - $454 324%
Encore Health $299 - $471 336%
Ameriben $303 - $454 341%
Indiana Criminal Justice Inst $314 - $471 353%
Western & Southern Financial Group $314 - $471 353%
Geha $322 - $482 362%
Healthscope $322 - $482 362%
Student Insurance Cma $322 - $482 362%
Cigna $323 - $484 363%
Group Administrators $323 - $484 363%
Health Partners $323 - $484 363%
Mvp $323 - $484 363%
Prairie States $323 - $484 363%
Priority Health $323 - $484 363%
Professional Benefit Administrators $323 - $484 363%
Sagamore Health Network $323 - $560 363%
Sisco Benefits $323 - $484 363%
Unified Group Services $323 - $484 363%
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 $328 - $492 369%
Christian Brother Services $328 - $492 369%
Employee Benefit Management $328 - $492 369%
Medical Mutual $328 - $492 369%
Meritain $328 - $492 369%
Preferred One $328 - $492 369%
Rural Carrier Health Benefit Plan $328 - $492 369%
Webtpa $328 - $492 369%
Goshen Preferred Network $389 - $651 438%
Christian Brothers Holy Cross $404 - $606 454%
Signature Care $404 - $606 454%
Bankers Life Casualty $505 - $757 568%
Bureau Of Disability $505 - $757 568%
Wc Align Network $505 - $757 568%

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