CMS Price Transparency Data
X-ray, foot
Facility: Saint Joseph Regional Medical Center - Plymouth
Billing Code: 73630 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73630
- Insurance Median: $325
- Cash Discount Price: $405
- vs. Medicare Baseline: 3.66x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Saint Joseph Regional Medical Center - Plymouth is $325. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $405. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.66x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$405
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: $405 (456%)
Insurance Median: $325 (366%)
Cash: $405 (456% 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.
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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 - $486 | 54% |
| Blue Cross Blue Shield | $48 - $325 | 54% |
| Medicaid / KanCare | $48 - $63 | 54% |
| UnitedHealthcare | $48 - $476 | 54% |
| Managed Health Services - Indiana | $63 | 71% |
| Mdwise | $63 | 71% |
| 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 - $202 | 152% |
| Auxiant | $138 - $620 | 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 - $524 | 187% |
| Allied Benefit Systems | $175 - $486 | 197% |
| Custom Design Benefits | $198 | 223% |
| Notre Dame Athletic Association | $274 - $411 | 308% |
| Wc Notre Dame | $274 - $411 | 308% |
| Luminare Health (Detroit) | $284 - $448 | 319% |
| Ameriben | $299 - $448 | 336% |
| Geha | $318 - $476 | 358% |
| Healthscope | $318 - $476 | 358% |
| Student Insurance Cma | $318 - $476 | 358% |
| Asr Health Benefits | $324 - $486 | 364% |
| Christian Brother Services | $324 - $486 | 364% |
| Employee Benefit Management | $324 - $486 | 364% |
| Medical Mutual | $324 - $486 | 364% |
| Meritain | $324 - $486 | 364% |
| Preferred One | $324 - $486 | 364% |
| Rural Carrier Health Benefit Plan | $324 - $486 | 364% |
| Webtpa | $324 - $486 | 364% |
| 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 | $350 - $524 | 394% |
| Indiana Criminal Justice Inst | $350 - $524 | 394% |
| Western & Southern Financial Group | $350 - $524 | 394% |
| Cigna | $359 - $538 | 404% |
| Group Administrators | $359 - $538 | 404% |
| Health Partners | $359 - $538 | 404% |
| Mvp | $359 - $538 | 404% |
| Prairie States | $359 - $538 | 404% |
| Priority Health | $359 - $538 | 404% |
| Professional Benefit Administrators | $359 - $538 | 404% |
| Sagamore Health Network | $359 - $575 | 404% |
| Sisco Benefits | $359 - $538 | 404% |
| Unified Group Services | $359 - $538 | 404% |
| Goshen Preferred Network | $384 - $642 | 432% |
| Signature Care | $414 - $620 | 466% |
| Allied National Global Care | $449 - $672 | 505% |
| Asrm - Reliance Standard Life Insurance | $449 - $672 | 505% |
| Avmed Health Plan | $449 - $672 | 505% |
| Christian Care Ministry | $449 - $672 | 505% |
| Dean Health | $449 - $672 | 505% |
| Fallon Health | $449 - $672 | 505% |
| Family Life Insurance Company | $449 - $672 | 505% |
| Freedom Life Insurance Company | $449 - $672 | 505% |
| Ghc Scw | $449 - $672 | 505% |
| International Benefit Administrators | $449 - $672 | 505% |
| Lifetime Benefit Solutions | $449 - $672 | 505% |
| Manhattan Life | $449 - $672 | 505% |
| Medi Share | $449 - $672 | 505% |
| Multiplan | $449 - $672 | 505% |
| Pai | $449 - $672 | 505% |
| Pan-American Life | $449 - $672 | 505% |
| Paramount Hmo | $449 - $672 | 505% |
| Phcs | $449 - $672 | 505% |
| Philadelphia American Life Insurance | $449 - $672 | 505% |
| Trinity Health Share | $449 - $672 | 505% |
| Bankers Life Casualty | $499 - $747 | 561% |
| Bureau Of Disability | $499 - $747 | 561% |
| Wc Align Network | $499 - $747 | 561% |