How many shoppable procedure prices are published for St Joseph Health System, LLC?

St Joseph Health System, LLC in Fort Wayne, IN currently has 117 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do St Joseph Health System, LLC's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, St Joseph Health System, LLC's median negotiated commercial rate is 1.2× the regionally adjusted fair BaseRate benchmark.

What is St Joseph Health System, LLC's CMS Care Compare overall star rating?

CMS Care Compare assigns St Joseph Health System, LLC an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Proprietary 60 Beds · urban Updated: 2026-04-01

St Joseph Health System, LLC

702 Van Buren St., Fort Wayne, IN 46802 · 117 Priced Procedures · 72% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

Above Fair Market · Negotiate

1.16×vs. Fair Market Price

Typical commercial prices here are +16% above the fair benchmark (1.16×) even after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 66% of the Time

File Completeness100

Price Logic47

Peer Alignment62

Clean Billing97

Real Cash Discount100

Regional Benchmark Tier

3-Star CMS clinical quality rating paired with 1.16× fair market pricing.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 4,811), St Joseph Health System, LLC commands a 1.16× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#52 of 107 in IN · 47th State Percentile#1,884 of 3,385 in U.S. · 55th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.98× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 66% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 72% patient recommendation (66/100 safety score)
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.0× markup over Medicare rates
Commercial insurance median sits at 1.26× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 1.8× Medicare — verify per-unit billing on itemized statements
Consolidated metro market (HHI 4,811) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.7× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.65× Divergence

1.1× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+14% Upper Tail

Q25 0.98× · Q50 1.26× · Q75 1.44×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

2.0× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

3.1× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

2.6× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

2.4× MedicareFair

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.8× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

66% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 66/100Fair

Procedure Prices at St Joseph Health System, LLC

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$26,515	$19,087	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$25,311	$19,432	unverified
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$19,694	$17,936	1.1×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$11,694	$8,223	1.4×
C-section delivery (full package) CPT Code: `59510`	$2,170	$5,593	$2,975	1.9×
Vaginal delivery (full package) CPT Code: `59400`	$1,415	$4,838	$2,680	1.8×
Trauma team activation HCPCS Code: `G0390`	$3,185	$3,185	$1,453	unverified
Total knee replacement CPT Code: `27447`	$936	$936	$13,523	0.1×
Blood transfusion CPT Code: `36430`	$886	$934	$498	unverified
Total hip replacement CPT Code: `27130`	$904	$904	$13,413	0.1×
Bunion correction surgery CPT Code: `28296`	$772	$772	$3,446	0.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$496	$738	$511	1.4×
Cataract surgery with lens implant CPT Code: `66984`	$732	$732	$2,540	0.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,235	$632	$448	1.4×
Rabies immune globulin HCPCS Code: `90375`	$5,529	$490	$322	1.5×
MRI, knee or other leg joint CPT Code: `73721`	$1,487	$505	$369	1.4×
MRI, lower back (no contrast) CPT Code: `72148`	$829	$458	$338	1.4×
MRI, brain (no contrast) CPT Code: `70551`	$1,109	$464	$343	1.4×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$459	$459	$6,109	unverified
Inguinal hernia repair CPT Code: `49505`	$469	$469	$3,629	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$220	$480	$272	unverified
Breast lump removal CPT Code: `19120`	$418	$418	$3,875	0.1×
CT scan, head (with and without contrast) CPT Code: `70470`	$723	$371	$258	1.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,753	$391	$303	1.3×
Sleep study (overnight, in lab) CPT Code: `95810`	$365	$365	$1,021	0.4×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$379	$379	$3,372	0.1×
Colonoscopy with biopsy CPT Code: `45380`	$346	$346	$1,256	0.3×
CT scan, sinuses CPT Code: `70486`	$1,939	$364	$166	unverified
Psychiatric evaluation (first visit) CPT Code: `90791`	$108	$282	$185	1.5×
CT scan, head (with contrast) CPT Code: `70460`	$484	$306	$242	1.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$296	$296	$981	0.3×
CT scan, pelvis CPT Code: `72192`	$1,290	$262	$163	1.6×
Ultrasound, pelvis CPT Code: `76856`	$210	$221	$130	1.7×
CT scan, chest (no contrast) CPT Code: `71250`	$1,646	$243	$167	1.5×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,596	$243	$168	1.4×
CT scan, neck (cervical spine) CPT Code: `72125`	$2,037	$243	$169	1.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$481	$216	$126	1.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$263	$199	$132	1.5×
Ultrasound, abdomen (complete) CPT Code: `76700`	$136	$199	$134	1.5×
CT scan, head (no contrast) CPT Code: `70450`	$1,195	$221	$160	1.4×
Hepatitis B immune globulin HCPCS Code: `90371`	$879	$184	$151	1.2×
New patient office visit (30-44 min) CPT Code: `99203`	$60	$148	$110	1.3×
Office visit, established patient (30-39 min) CPT Code: `99214`	$61	$152	$123	1.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$369	$172	$148	1.2×
Upper endoscopy with biopsy CPT Code: `43239`	$181	$181	$987	0.2×
Screening mammogram (both breasts) CPT Code: `77067`	$326	$154	$123	1.3×
Speech therapy (language evaluation) CPT Code: `92507`	$140	$110	$86	1.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$128	$128	$583	0.2×
Office visit, established patient (20-29 min) CPT Code: `99213`	$29	$100	$87	1.1×
Psychotherapy session (60 minutes) CPT Code: `90837`	$95	$95	$181	0.5×
Typhoid vaccine HCPCS Code: `90675`	$1,342	$390	$347	1.1×
Pneumococcal vaccine HCPCS Code: `90732`	$361	$351	$140	unverified
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$95	$95	$27	3.5×
Diagnostic procedure preparation HCPCS Code: `G0279`	$24	$70	$35	2.0×
Orthotic fitting and training CPT Code: `97760`	$67	$66	$51	1.3×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$76	$91	$203	0.4×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$73	$111	$56	unverified
Flu vaccine injection HCPCS Code: `G0008`	$34	$74	$48	1.5×
Colorectal cancer screening HCPCS Code: `G0010`	$41	$74	$49	1.5×
Prosthetic fitting and training CPT Code: `97761`	$66	$58	$45	1.3×
Physical therapy (gait training) CPT Code: `97116`	$66	$42	$33	1.3×
Physical therapy (functional capacity test) CPT Code: `97750`	$66	$48	$38	1.3×
Speech therapy (group session) CPT Code: `92508`	$51	$34	$27	1.3×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$58	$50	$40	1.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$57	$47	$38	1.2×
Occupational therapy (self-care training) CPT Code: `97535`	$72	$46	$38	1.2×
Electrical stimulation therapy HCPCS Code: `G0283`	$71	$18	$14	1.3×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$76	$42	$35	1.2×
Blood antibody screen CPT Code: `86850`	$34	$55	$46	1.2×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$42	$77	$39	unverified
Pneumonia vaccine injection HCPCS Code: `G0009`	$34	$74	$49	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$59	$40	$34	1.2×
Hepatitis B vaccine HCPCS Code: `90744`	$47	$34	$37	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$46	$46	$111	0.4×
Flu vaccine (high dose) HCPCS Code: `90656`	$50	$44	$25	unverified
Psychotherapy session (45 minutes) CPT Code: `90834`	$63	$63	$166	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$9	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$27	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$4	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$3	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$3	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$2	$3	$3	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$5	$6	$6	1.0×
Culture, bacterial CPT Code: `87070`	$8	$9	$9	1.0×
Blood test, vitamin D CPT Code: `82306`	$21	$30	$31	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$7	$4	$3	1.3×
Blood test, amylase CPT Code: `82150`	$7	$7	$7	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$5	$5	$5	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$19	$19	$20	0.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$16	$18	$19	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$14	$15	$16	0.9×
Hepatitis C antibody test CPT Code: `86803`	$12	$14	$15	0.9×
Blood test, ferritin (iron stores) CPT Code: `82728`	$13	$13	$14	0.9×
Culture, blood CPT Code: `87040`	$12	$10	$11	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$5	$8	$9	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$20	$16	$18	0.9×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$27	$21	$25	0.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$35	$35	$201	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$4	$4	$5	0.8×
Blood test, glucose (blood sugar) CPT Code: `82947`	$4	$3	$4	0.8×
Blood test, complete blood count (CBC) CPT Code: `85025`	$6	$6	$8	0.8×
Blood test, magnesium CPT Code: `83735`	$4	$5	$7	0.7×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$8	$9	$14	0.6×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$29	$29	$64	0.5×
X-ray, hip CPT Code: `73502`	$28	$28	$93	0.3×
X-ray, lower back CPT Code: `72110`	$33	$33	$112	0.3×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$5	$7	$11	0.6×
Blood test, calcium CPT Code: `82310`	$3	$3	$5	0.6×
Blood test, liver function panel CPT Code: `80076`	$4	$5	$9	0.6×
X-ray, chest (two views) CPT Code: `71046`	$27	$27	$93	0.3×
X-ray, neck (cervical spine) CPT Code: `72040`	$24	$24	$93	0.3×
X-ray, hand CPT Code: `73130`	$22	$22	$93	0.2×
X-ray, ankle CPT Code: `73610`	$22	$22	$93	0.2×
X-ray, shoulder CPT Code: `73030`	$21	$21	$92	0.2×
X-ray, foot CPT Code: `73630`	$20	$20	$92	0.2×
X-ray, chest (single view) CPT Code: `71045`	$18	$18	$92	0.2×
X-ray, pelvis CPT Code: `72170`	$17	$17	$110	0.2×

Showing top 25 high-impact procedures of 117 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at St Joseph Health System, LLC (Zero PHI Required)

CMS CCN: 150047

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash Request Quote

Insurer Median $26,515

1. Amount on Your Bill or Quote ($) Pre-filled with St Joseph Health System, LLC’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask St Joseph Health System, LLC's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$44,549 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($63,636) is $44,549 above the denoised Fair BaseRate ($19,087) and 4.5× the $14,117 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 510382045

Public IRS & CMS ownership records classify St Joseph Health System, LLC as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite66/100

Would Recommend72%

Rated 9 or 10 (HCAHPS)74%

Median ER Wait131 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

Source: CMS Hospital Care Compare (249 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for St Joseph Health System, LLC.

Price Index: 0.86× regional baseline

Quality: 57/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Humana

-46.6%

Median Household Income$68,839U.S. Census ACS

Local Uninsured Share8.2%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 79/100 · Corroborated CMS CCN 150047 EIN 510382045

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 150047) ↗ Verify IRS Form 990 (EIN 510382045) ↗ CMS HCRIS Cost Reports ↗

Published MRF File510382045_lutheran-downtown-hospital_standardcharges.csv

Publication / Vintage2026-04-01 · 1098.62 MB

Validated Rate Rows37,654 (CMS v3.0.0)

File Integrity Digest079a5285f353be3904bc…

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy