CMS Price Transparency Data

X-ray, hip

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73502
  • Insurance Median: $313
  • Cash Discount Price: $321
  • vs. Medicare Baseline: 3.52x Medicare
The contracted insurance negotiated median rate for a X-ray, hip at Saint Joseph Regional Medical Center - Plymouth is $313. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.52x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$321

Average discount available for prompt cash payment at this facility.

Insurance Median
$313

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: $321 (361%)
Insurance Median: $313 (352%)
Cash: $321 (361% of Medicare)
Ins. Median: $313 (352% 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 352% of the Medicare baseline (a markup of 252%). 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
Aetna $48 - $321 54%
Blue Cross Blue Shield $48 - $325 54%
Medicaid / KanCare $48 - $81 54%
UnitedHealthcare $48 - $315 54%
Managed Health Services - Indiana $81 91%
Mdwise $81 91%
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 $133 150%
Auxiant $138 - $410 155%
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 - $346 187%
Allied Benefit Systems $175 - $321 197%
Custom Design Benefits $198 223%
Notre Dame Athletic Association $272 306%
Wc Notre Dame $272 306%
Luminare Health (Detroit) $282 - $296 317%
Ameriben $296 333%
Geha $315 354%
Healthscope $315 354%
Student Insurance Cma $315 354%
Asr Health Benefits $321 361%
Christian Brother Services $321 361%
Employee Benefit Management $321 361%
Medical Mutual $321 361%
Meritain $321 361%
Preferred One $321 361%
Rural Carrier Health Benefit Plan $321 361%
Webtpa $321 361%
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 $346 389%
Indiana Criminal Justice Inst $346 389%
Western & Southern Financial Group $346 389%
Cigna $356 400%
Group Administrators $356 400%
Health Partners $356 400%
Mvp $356 400%
Prairie States $356 400%
Priority Health $356 400%
Professional Benefit Administrators $356 400%
Sagamore Health Network $356 - $380 400%
Sisco Benefits $356 400%
Unified Group Services $356 400%
Goshen Preferred Network $380 - $425 427%
Signature Care $410 461%
Allied National Global Care $445 501%
Asrm - Reliance Standard Life Insurance $445 501%
Avmed Health Plan $445 501%
Christian Care Ministry $445 501%
Dean Health $445 501%
Fallon Health $445 501%
Family Life Insurance Company $445 501%
Freedom Life Insurance Company $445 501%
Ghc Scw $445 501%
International Benefit Administrators $445 501%
Lifetime Benefit Solutions $445 501%
Manhattan Life $445 501%
Medi Share $445 501%
Multiplan $445 501%
Pai $445 501%
Pan-American Life $445 501%
Paramount Hmo $445 501%
Phcs $445 501%
Philadelphia American Life Insurance $445 501%
Trinity Health Share $445 501%
Bankers Life Casualty $494 556%
Bureau Of Disability $494 556%
Wc Align Network $494 556%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals