CMS Price Transparency Data

X-ray, lower back

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $545
  • Cash Discount Price: $556
  • vs. Medicare Baseline: 5.10x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Saint Joseph Regional Medical Center - Plymouth is $545. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $556. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.10x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$556

Average discount available for prompt cash payment at this facility.

Insurance Median
$545

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $556 (521%)
Insurance Median: $545 (510%)
Cash: $556 (521% of Medicare)
Ins. Median: $545 (510% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 510% of the Medicare baseline (a markup of 410%). 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 $57 - $556 53%
Blue Cross Blue Shield $57 - $391 53%
Medicaid / KanCare $57 - $91 53%
UnitedHealthcare $57 - $545 53%
Managed Health Services - Indiana $91 85%
Mdwise $91 85%
Medicare (plans) $111 - $113 104%
Meridian Complete $111 104%
Pace-Trinity Health $111 104%
County Coroner $115 108%
Provider Partners Health Plan Of Indiana $122 114%
Auxiant $166 - $710 155%
Physicians Health Plan Northern Indiana Health Insurance $166 - $334 155%
St Joseph County Hlth Dpt $166 155%
Caresource $171 160%
Siho Insurance Services $177 166%
Key Benefit Administrator $199 - $600 186%
Allied Benefit Systems $210 - $556 197%
Plain Church Group $231 216%
Custom Design Benefits $238 223%
Blue Benefit Administrators Of Massachusetts $391 366%
Blue Care Network $391 366%
Blue Distinction Transplant $391 366%
Blue Shield - Ca $391 366%
Blue Shield - Id (Regence) $391 366%
Blue Shield - Ny Highmark Northeastern $391 366%
Blue Shield - Ny Highmark Western $391 366%
Blue Shield - Pa (Highmark) $391 366%
Blue Shield - Wa (Regence) $391 366%
Notre Dame Athletic Association $471 441%
Wc Notre Dame $471 441%
Luminare Health (Detroit) $488 - $514 457%
Ameriben $514 481%
Geha $545 510%
Healthscope $545 510%
Student Insurance Cma $545 510%
Asr Health Benefits $556 521%
Christian Brother Services $556 521%
Employee Benefit Management $556 521%
Medical Mutual $556 521%
Meritain $556 521%
Preferred One $556 521%
Rural Carrier Health Benefit Plan $556 521%
Webtpa $556 521%
Encore Health $600 562%
Indiana Criminal Justice Inst $600 562%
Western & Southern Financial Group $600 562%
Cigna $616 577%
Group Administrators $616 577%
Health Partners $616 577%
Mvp $616 577%
Prairie States $616 577%
Priority Health $616 577%
Professional Benefit Administrators $616 577%
Sagamore Health Network $616 - $659 577%
Sisco Benefits $616 577%
Unified Group Services $616 577%
Goshen Preferred Network $659 - $736 617%
Signature Care $710 665%
Allied National Global Care $770 721%
Asrm - Reliance Standard Life Insurance $770 721%
Avmed Health Plan $770 721%
Christian Care Ministry $770 721%
Dean Health $770 721%
Fallon Health $770 721%
Family Life Insurance Company $770 721%
Freedom Life Insurance Company $770 721%
Ghc Scw $770 721%
International Benefit Administrators $770 721%
Lifetime Benefit Solutions $770 721%
Manhattan Life $770 721%
Medi Share $770 721%
Multiplan $770 721%
Pai $770 721%
Pan-American Life $770 721%
Paramount Hmo $770 721%
Phcs $770 721%
Philadelphia American Life Insurance $770 721%
Trinity Health Share $770 721%
Bankers Life Casualty $856 801%
Bureau Of Disability $856 801%
Wc Align Network $856 801%

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