CMS Price Transparency Data
X-ray, hand
Facility: Saint Joseph Regional Medical Center - Plymouth
Billing Code: 73130 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73130
- Insurance Median: $328
- Cash Discount Price: $410
- vs. Medicare Baseline: 3.69x Medicare
The contracted insurance negotiated median rate for a X-ray, hand at Saint Joseph Regional Medical Center - Plymouth is $328. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $410. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.69x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$410
Average discount available for prompt cash payment at this facility.
Insurance Median
$328
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: $410 (461%)
Insurance Median: $328 (369%)
Cash: $410 (461% of Medicare)
Ins. Median: $328 (369% 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 369% of the Medicare baseline (a markup of 269%). 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 - $492 | 54% |
| Blue Cross Blue Shield | $48 - $325 | 54% |
| Medicaid / KanCare | $48 - $66 | 54% |
| UnitedHealthcare | $48 - $482 | 54% |
| Managed Health Services - Indiana | $66 | 74% |
| Mdwise | $66 | 74% |
| 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 | $136 - $204 | 153% |
| Auxiant | $138 - $628 | 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 - $531 | 187% |
| Allied Benefit Systems | $175 - $492 | 197% |
| Custom Design Benefits | $198 | 223% |
| Notre Dame Athletic Association | $278 - $416 | 313% |
| Wc Notre Dame | $278 - $416 | 313% |
| Luminare Health (Detroit) | $288 - $454 | 324% |
| Ameriben | $303 - $454 | 341% |
| Geha | $322 - $482 | 362% |
| Healthscope | $322 - $482 | 362% |
| Student Insurance Cma | $322 - $482 | 362% |
| 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 | $328 - $492 | 369% |
| Christian Brother Services | $328 - $492 | 369% |
| Employee Benefit Management | $328 - $492 | 369% |
| Medical Mutual | $328 - $492 | 369% |
| Meritain | $328 - $492 | 369% |
| Preferred One | $328 - $492 | 369% |
| Rural Carrier Health Benefit Plan | $328 - $492 | 369% |
| Webtpa | $328 - $492 | 369% |
| Encore Health | $354 - $531 | 398% |
| Indiana Criminal Justice Inst | $354 - $531 | 398% |
| Western & Southern Financial Group | $354 - $531 | 398% |
| Cigna | $364 - $545 | 409% |
| Group Administrators | $364 - $545 | 409% |
| Health Partners | $364 - $545 | 409% |
| Mvp | $364 - $545 | 409% |
| Prairie States | $364 - $545 | 409% |
| Priority Health | $364 - $545 | 409% |
| Professional Benefit Administrators | $364 - $545 | 409% |
| Sagamore Health Network | $364 - $583 | 409% |
| Sisco Benefits | $364 - $545 | 409% |
| Unified Group Services | $364 - $545 | 409% |
| Goshen Preferred Network | $389 - $651 | 438% |
| Signature Care | $419 - $628 | 471% |
| Allied National Global Care | $454 - $681 | 511% |
| Asrm - Reliance Standard Life Insurance | $454 - $681 | 511% |
| Avmed Health Plan | $454 - $681 | 511% |
| Christian Care Ministry | $454 - $681 | 511% |
| Dean Health | $454 - $681 | 511% |
| Fallon Health | $454 - $681 | 511% |
| Family Life Insurance Company | $454 - $681 | 511% |
| Freedom Life Insurance Company | $454 - $681 | 511% |
| Ghc Scw | $454 - $681 | 511% |
| International Benefit Administrators | $454 - $681 | 511% |
| Lifetime Benefit Solutions | $454 - $681 | 511% |
| Manhattan Life | $454 - $681 | 511% |
| Medi Share | $454 - $681 | 511% |
| Multiplan | $454 - $681 | 511% |
| Pai | $454 - $681 | 511% |
| Pan-American Life | $454 - $681 | 511% |
| Paramount Hmo | $454 - $681 | 511% |
| Phcs | $454 - $681 | 511% |
| Philadelphia American Life Insurance | $454 - $681 | 511% |
| Trinity Health Share | $454 - $681 | 511% |
| Bankers Life Casualty | $505 - $757 | 568% |
| Bureau Of Disability | $505 - $757 | 568% |
| Wc Align Network | $505 - $757 | 568% |