CMS Price Transparency Data

X-ray, pelvis

Facility: Saint Joseph Regional Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $272
  • Cash Discount Price: $284
  • vs. Medicare Baseline: 2.55x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Saint Joseph Regional Medical Center is $272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $284. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.55x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$284

Average discount available for prompt cash payment at this facility.

Insurance Median
$272

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: $284 (266%)
Insurance Median: $272 (255%)
Cash: $284 (266% of Medicare)
Ins. Median: $272 (255% 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 255% of the Medicare baseline (a markup of 155%). 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
Bureau Of Disability $41 38%
Blue Cross Blue Shield $54 - $391 51%
Managed Health Services - Indiana $54 51%
Mdwise $54 51%
Medicaid / KanCare $54 - $57 51%
UnitedHealthcare $54 - $278 51%
Aetna $57 - $284 53%
Medicare (plans) $111 - $113 104%
Meridian Complete $111 104%
Pace-Trinity Health $111 104%
Hospice Of Marshall County $114 107%
Hospice Of St Joseph County $114 107%
County Coroner $115 108%
Plain Church Group $118 110%
Provider Partners Health Plan Of Indiana $122 114%
Auxiant $166 - $363 155%
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 - $272 186%
Allied Benefit Systems $210 - $284 197%
Custom Design Benefits $238 223%
Notre Dame Athletic Association $240 225%
Wc Notre Dame $240 225%
Luminare Health (Detroit) $249 - $262 233%
Encore Health $259 - $272 242%
Ameriben $262 245%
Indiana Criminal Justice Inst $272 255%
Western & Southern Financial Group $272 255%
Geha $278 260%
Healthscope $278 260%
Student Insurance Cma $278 260%
Cigna $280 262%
Group Administrators $280 262%
Health Partners $280 262%
Mvp $280 262%
Prairie States $280 262%
Priority Health $280 262%
Professional Benefit Administrators $280 262%
Sagamore Health Network $280 - $323 262%
Sisco Benefits $280 262%
Unified Group Services $280 262%
Asr Health Benefits $284 266%
Christian Brother Services $284 266%
Employee Benefit Management $284 266%
Medical Mutual $284 266%
Meritain $284 266%
Preferred One $284 266%
Rural Carrier Health Benefit Plan $284 266%
Webtpa $284 266%
Goshen Preferred Network $336 - $376 315%
Christian Brothers Holy Cross $350 328%
Signature Care $350 328%
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%
Bankers Life Casualty $437 409%
Wc Align Network $437 409%

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