CMS Price Transparency Data
X-ray, ankle
Facility: Saint Joseph Regional Medical Center - Plymouth
Billing Code: 73610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73610
- Insurance Median: $326
- Cash Discount Price: $407
- vs. Medicare Baseline: 3.67x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at Saint Joseph Regional Medical Center - Plymouth is $326. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.67x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$407
Average discount available for prompt cash payment at this facility.
Insurance Median
$326
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: $407 (458%)
Insurance Median: $326 (367%)
Cash: $407 (458% of Medicare)
Ins. Median: $326 (367% 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 367% of the Medicare baseline (a markup of 267%). 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.
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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 - $488 | 54% |
| Blue Cross Blue Shield | $48 - $325 | 54% |
| Medicaid / KanCare | $48 - $68 | 54% |
| UnitedHealthcare | $48 - $478 | 54% |
| Managed Health Services - Indiana | $68 | 76% |
| Mdwise | $68 | 76% |
| 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% |
| Plain Church Group | $135 - $203 | 152% |
| Auxiant | $138 - $623 | 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 - $527 | 187% |
| Allied Benefit Systems | $175 - $488 | 197% |
| Custom Design Benefits | $198 | 223% |
| Notre Dame Athletic Association | $276 - $413 | 310% |
| Wc Notre Dame | $276 - $413 | 310% |
| Luminare Health (Detroit) | $286 - $451 | 322% |
| Ameriben | $301 - $451 | 339% |
| Geha | $319 - $478 | 359% |
| Healthscope | $319 - $478 | 359% |
| Student Insurance Cma | $319 - $478 | 359% |
| 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 | $326 - $488 | 367% |
| Christian Brother Services | $326 - $488 | 367% |
| Employee Benefit Management | $326 - $488 | 367% |
| Medical Mutual | $326 - $488 | 367% |
| Meritain | $326 - $488 | 367% |
| Preferred One | $326 - $488 | 367% |
| Rural Carrier Health Benefit Plan | $326 - $488 | 367% |
| Webtpa | $326 - $488 | 367% |
| Encore Health | $351 - $527 | 395% |
| Indiana Criminal Justice Inst | $351 - $527 | 395% |
| Western & Southern Financial Group | $351 - $527 | 395% |
| Cigna | $361 - $541 | 406% |
| Group Administrators | $361 - $541 | 406% |
| Health Partners | $361 - $541 | 406% |
| Mvp | $361 - $541 | 406% |
| Prairie States | $361 - $541 | 406% |
| Priority Health | $361 - $541 | 406% |
| Professional Benefit Administrators | $361 - $541 | 406% |
| Sagamore Health Network | $361 - $578 | 406% |
| Sisco Benefits | $361 - $541 | 406% |
| Unified Group Services | $361 - $541 | 406% |
| Goshen Preferred Network | $386 - $646 | 434% |
| Signature Care | $416 - $623 | 468% |
| Allied National Global Care | $451 - $676 | 507% |
| Asrm - Reliance Standard Life Insurance | $451 - $676 | 507% |
| Avmed Health Plan | $451 - $676 | 507% |
| Christian Care Ministry | $451 - $676 | 507% |
| Dean Health | $451 - $676 | 507% |
| Fallon Health | $451 - $676 | 507% |
| Family Life Insurance Company | $451 - $676 | 507% |
| Freedom Life Insurance Company | $451 - $676 | 507% |
| Ghc Scw | $451 - $676 | 507% |
| International Benefit Administrators | $451 - $676 | 507% |
| Lifetime Benefit Solutions | $451 - $676 | 507% |
| Manhattan Life | $451 - $676 | 507% |
| Medi Share | $451 - $676 | 507% |
| Multiplan | $451 - $676 | 507% |
| Pai | $451 - $676 | 507% |
| Pan-American Life | $451 - $676 | 507% |
| Paramount Hmo | $451 - $676 | 507% |
| Phcs | $451 - $676 | 507% |
| Philadelphia American Life Insurance | $451 - $676 | 507% |
| Trinity Health Share | $451 - $676 | 507% |
| Bankers Life Casualty | $501 - $751 | 563% |
| Bureau Of Disability | $501 - $751 | 563% |
| Wc Align Network | $501 - $751 | 563% |