CMS Price Transparency Data

X-ray, shoulder

Facility: Saint Joseph Regional Medical Center

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $325
  • Cash Discount Price: $452
  • vs. Medicare Baseline: 3.66x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Saint Joseph Regional Medical Center is $325. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $452. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.66x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$452

Average discount available for prompt cash payment at this facility.

Insurance Median
$325

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: $452 (508%)
Insurance Median: $325 (366%)
Cash: $452 (508% of Medicare)
Ins. Median: $325 (366% 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 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
Bureau Of Disability $41 46%
Aetna $48 - $543 54%
Blue Cross Blue Shield $48 - $325 54%
Medicaid / KanCare $48 - $58 54%
UnitedHealthcare $48 - $532 54%
Managed Health Services - Indiana $58 65%
Mdwise $58 65%
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%
Auxiant $138 - $693 155%
Physicians Health Plan Northern Indiana Health Insurance $138 - $278 155%
St Joseph County Hlth Dpt $138 155%
Caresource $143 161%
Hospice Of Marshall County $145 - $217 163%
Hospice Of St Joseph County $145 - $217 163%
Siho Insurance Services $147 165%
Plain Church Group $150 - $225 169%
Key Benefit Administrator $166 - $520 187%
Allied Benefit Systems $175 - $543 197%
Custom Design Benefits $198 223%
Notre Dame Athletic Association $306 - $459 344%
Wc Notre Dame $306 - $459 344%
Luminare Health (Detroit) $317 - $501 357%
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%
Encore Health $330 - $520 371%
Ameriben $334 - $501 376%
Indiana Criminal Justice Inst $347 - $520 390%
Western & Southern Financial Group $347 - $520 390%
Geha $355 - $532 399%
Healthscope $355 - $532 399%
Student Insurance Cma $355 - $532 399%
Cigna $356 - $534 400%
Group Administrators $356 - $534 400%
Health Partners $356 - $534 400%
Mvp $356 - $534 400%
Prairie States $356 - $534 400%
Priority Health $356 - $534 400%
Professional Benefit Administrators $356 - $534 400%
Sagamore Health Network $356 - $618 400%
Sisco Benefits $356 - $534 400%
Unified Group Services $356 - $534 400%
Asr Health Benefits $362 - $543 407%
Christian Brother Services $362 - $543 407%
Employee Benefit Management $362 - $543 407%
Medical Mutual $362 - $543 407%
Meritain $362 - $543 407%
Preferred One $362 - $543 407%
Rural Carrier Health Benefit Plan $362 - $543 407%
Webtpa $362 - $543 407%
Goshen Preferred Network $429 - $718 483%
Christian Brothers Holy Cross $446 - $668 502%
Signature Care $446 - $668 502%
Bankers Life Casualty $557 - $835 626%
Wc Align Network $557 - $835 626%

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