CMS Price Transparency Data

X-ray, hip

Facility: Saint Joseph Regional Medical Center

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73502
  • Insurance Median: $198
  • Cash Discount Price: $495
  • vs. Medicare Baseline: 2.23x Medicare
The contracted insurance negotiated median rate for a X-ray, hip at Saint Joseph Regional Medical Center is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $495. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.23x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$495

Average discount available for prompt cash payment at this facility.

Insurance Median
$198

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: $495 (557%)
Insurance Median: $198 (223%)
Cash: $495 (557% of Medicare)
Ins. Median: $198 (223% 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 223% of the Medicare baseline (a markup of 123%). 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 - $321 54%
Blue Cross Blue Shield $48 - $325 54%
Medicaid / KanCare $48 - $81 54%
UnitedHealthcare $48 - $315 54%
Managed Health Services - Indiana $81 91%
Mdwise $81 91%
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 $128 144%
Hospice Of St Joseph County $128 144%
Plain Church Group $133 150%
Auxiant $138 - $410 155%
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 - $307 187%
Allied Benefit Systems $175 - $321 197%
Custom Design Benefits $198 223%
Notre Dame Athletic Association $272 306%
Wc Notre Dame $272 306%
Luminare Health (Detroit) $282 - $296 317%
Encore Health $293 - $307 330%
Ameriben $296 333%
Indiana Criminal Justice Inst $307 345%
Western & Southern Financial Group $307 345%
Geha $315 354%
Healthscope $315 354%
Student Insurance Cma $315 354%
Cigna $316 355%
Group Administrators $316 355%
Health Partners $316 355%
Mvp $316 355%
Prairie States $316 355%
Priority Health $316 355%
Professional Benefit Administrators $316 355%
Sagamore Health Network $316 - $366 355%
Sisco Benefits $316 355%
Unified Group Services $316 355%
Asr Health Benefits $321 361%
Christian Brother Services $321 361%
Employee Benefit Management $321 361%
Medical Mutual $321 361%
Meritain $321 361%
Preferred One $321 361%
Rural Carrier Health Benefit Plan $321 361%
Webtpa $321 361%
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%
Goshen Preferred Network $380 - $425 427%
Christian Brothers Holy Cross $395 444%
Signature Care $395 444%
Bankers Life Casualty $494 556%
Bureau Of Disability $494 556%
Wc Align Network $494 556%

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