CMS Price Transparency Data

X-ray, lower back

Facility: Saint Joseph Regional Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $391
  • Cash Discount Price: $556
  • vs. Medicare Baseline: 3.66x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Saint Joseph Regional Medical Center is $391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $556. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.66x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$556

Average discount available for prompt cash payment at this facility.

Insurance Median
$391

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: $556 (521%)
Insurance Median: $391 (366%)
Cash: $556 (521% of Medicare)
Ins. Median: $391 (366% 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 366% of the Medicare baseline (a markup of 266%). 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 - $556 53%
Blue Cross Blue Shield $57 - $391 53%
Medicaid / KanCare $57 - $91 53%
UnitedHealthcare $57 - $545 53%
Managed Health Services - Indiana $91 85%
Mdwise $91 85%
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 - $710 155%
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 - $533 186%
Allied Benefit Systems $210 - $556 197%
Hospice Of Marshall County $223 209%
Hospice Of St Joseph County $223 209%
Plain Church Group $231 216%
Custom Design Benefits $238 223%
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%
Notre Dame Athletic Association $471 441%
Wc Notre Dame $471 441%
Luminare Health (Detroit) $488 - $514 457%
Encore Health $507 - $533 475%
Ameriben $514 481%
Indiana Criminal Justice Inst $533 499%
Western & Southern Financial Group $533 499%
Geha $545 510%
Healthscope $545 510%
Student Insurance Cma $545 510%
Cigna $548 513%
Group Administrators $548 513%
Health Partners $548 513%
Mvp $548 513%
Prairie States $548 513%
Priority Health $548 513%
Professional Benefit Administrators $548 513%
Sagamore Health Network $548 - $633 513%
Sisco Benefits $548 513%
Unified Group Services $548 513%
Asr Health Benefits $556 521%
Christian Brother Services $556 521%
Employee Benefit Management $556 521%
Medical Mutual $556 521%
Meritain $556 521%
Preferred One $556 521%
Rural Carrier Health Benefit Plan $556 521%
Webtpa $556 521%
Goshen Preferred Network $659 - $736 617%
Christian Brothers Holy Cross $685 641%
Signature Care $685 641%
Bankers Life Casualty $856 801%
Bureau Of Disability $856 801%
Wc Align Network $856 801%

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