Saint Joseph Regional Medical Center - Plymouth

1915 Lake Ave, Plymouth, IN 46563 · (574) 948-4000

Acute Care HospitalsVoluntary non-profit - ChurchCMS rating 4/5Plymouth, IN metro Part of Trinity Health · 52 hospitals Website ↗

Price file

Prices published

File dated 2026-03-31

36,634 price rows for 47 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 3 lines · metro median $149

$149

cash

$5 to $229

455 negotiated rates

$229

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · metro median $4,152

$4,152

cash

$191 to $6,388

174 negotiated rates

$6,388

list

CT scan of the head, no contrast

CPT 70450 · lowest of 2 lines · metro median $1,480

$1,480

cash

$57 to $2,277

286 negotiated rates

$2,277

list

CT scan of the pelvis, with contrast

CPT 72193 · metro median $2,299

$2,299

cash

$96 to $3,537

174 negotiated rates

$3,537

list

Cataract surgery with lens implant

CPT 66984 · metro median $7,893

$7,893

cash

$1,264 to $8,621

107 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 14 lines · metro median $288

$288

cash

$20 to $443

2369 negotiated rates

$443

list

Colonoscopy (diagnostic)

CPT 45378 · lowest of 3 lines · metro median $430

$430

cash

$58 to $3,474

1625 negotiated rates

$430

list

Colonoscopy with biopsy

CPT 45380 · lowest of 3 lines · metro median $517

$517

cash

$63 to $4,470

1626 negotiated rates

$517

list

Colonoscopy with polyp removal

CPT 45385 · lowest of 3 lines · metro median $551

$551

cash

$65 to $4,470

1626 negotiated rates

$551

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 2 lines · metro median $79

$79

cash

$4 to $122

348 negotiated rates

$122

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 2 lines · metro median $199

$199

cash

$6 to $306

348 negotiated rates

$306

list

Diagnostic mammogram (both breasts)

CPT 77066 · metro median $492

$492

cash

$60 to $757

174 negotiated rates

$757

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 2 lines · metro median $306

$306

cash

$98 to $386

1518 negotiated rates

$306

list

Gallbladder removal (laparoscopic)

CPT 47562 · lowest of 3 lines · metro median $1,396

$1,396

cash

$214 to $22,582

1625 negotiated rates

$1,396

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 14 lines · metro median $166

$166

cash

$20 to $256

2369 negotiated rates

$256

list

Hospital stay for digestive disorders, no complications

MS-DRG 392 · metro median $16,763

$16,763

cash

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · lowest of 3 lines · metro median $1,157

$1,157

cash

$170 to $13,374

1625 negotiated rates

$1,157

list

Knee arthroscopy with meniscus repair

CPT 29881 · metro median $18,199

$18,199

cash

$1,792 to $12,222

107 negotiated rates

—

list

Left heart catheterization

CPT 93452 · metro median $10,095

$10,095

cash

$1,775 to $15,530

174 negotiated rates

$15,530

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 3 lines · metro median $176

$176

cash

$7 to $271

522 negotiated rates

$271

list

Liver function panel

CPT 80076 · metro median $183

$183

cash

$5 to $282

174 negotiated rates

$282

list

MRI of the brain, with and without contrast

CPT 70553 · metro median $3,763

$3,763

cash

$191 to $5,789

173 negotiated rates

$5,789

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · lowest of 3 lines · metro median $2,971

$2,971

cash

$131 to $6,854

519 negotiated rates

$4,570

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · metro median $3,026

$3,026

cash

$131 to $4,655

173 negotiated rates

$4,655

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · metro median $3,026

$3,026

cash

$131 to $4,655

173 negotiated rates

$4,655

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · lowest of 3 lines · metro median $1,368

$1,368

cash

$484 to $3,304

522 negotiated rates

$2,104

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 2 lines · metro median $175

$175

cash

$54 to $238

1518 negotiated rates

$175

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 2 lines · metro median $285

$285

cash

$85 to $356

1518 negotiated rates

$285

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 2 lines · metro median $388

$388

cash

$116 to $471

1518 negotiated rates

$388

list

PSA test (prostate)

CPT 84153 · lowest of 3 lines · metro median $161

$161

cash

$10 to $252

522 negotiated rates

$247

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 6 lines · metro median $78

$78

cash

$3 to $120

1044 negotiated rates

$120

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 2 lines · metro median $118

$118

cash

$16 to $186

348 negotiated rates

$181

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · metro median $744

$744

cash

$57 to $1,145

174 negotiated rates

$1,145

list

Prostate biopsy

CPT 55700 · lowest of 3 lines · metro median $291

$291

cash

$27 to $7,808

1612 negotiated rates

$307

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 6 lines · metro median $54

$54

cash

$2 to $83

1044 negotiated rates

$83

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · lowest of 3 lines · metro median $930

$930

cash

$136 to $14,626

1625 negotiated rates

$930

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 2 lines · metro median $257

$257

cash

$49 to $460

348 negotiated rates

$396

list

Sleep study (overnight, attended)

CPT 95810 · metro median $3,340

$3,340

cash

$470 to $5,138

174 negotiated rates

$5,138

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · metro median $1,370

$1,370

cash

$484 to $3,304

165 negotiated rates

$2,107

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · metro median $1,370

$1,370

cash

$387 to $2,637

174 negotiated rates

$2,107

list

TSH test (thyroid)

CPT 84443 · lowest of 5 lines · metro median $161

$161

cash

$9 to $247

870 negotiated rates

$247

list

Transvaginal ultrasound

CPT 76830 · metro median $729

$729

cash

$57 to $1,122

174 negotiated rates

$1,122

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 2 lines · metro median $1,016

$1,016

cash

$57 to $1,563

281 negotiated rates

$1,563

list

Upper endoscopy (EGD)

CPT 43235 · lowest of 2 lines · metro median $297

$297

cash

$39 to $3,388

1625 negotiated rates

$297

list

Upper endoscopy with biopsy

CPT 43239 · lowest of 3 lines · metro median $301

$301

cash

$32 to $3,388

1626 negotiated rates

$301

list

Urinalysis with microscope

CPT 81001 · lowest of 4 lines · metro median $57

$57

cash

$2 to $87

629 negotiated rates

$87

list

X-ray of the lower spine (4 or more views)

CPT 72110 · metro median $556

$556

cash

$57 to $856

174 negotiated rates

$856

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://hpt.trinity-health.org/351142669_plymouth-medical-center_standardcharges.zip
Saint Joseph Regional Medical Center-Plymouth Campus · parsed · tall v3.0.0 · file dated 2026-03-31 · 141.2 MB · 36634 price rows read · read Nov 2026