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Short Term Acute Care HospitalVoluntary Non-Profit - Private

Mishawaka Medical Center

Trinity Health · Mishawaka, IN

5215 Holy Cross Parkway, Mishawaka, IN 46545(574) 335-5000

2 of 5

CMS star rating

253

Beds

11,826

Inpatient discharges a year

$409.5M

Net patient revenue a year

20

In-network payers

About this hospital

Mishawaka Medical Center is a 253-bed voluntary non-profit - private hospital in Mishawaka, IN, affiliated with Trinity Health. Below you'll find publicly disclosed negotiated rates and facility details, including 20 in-network payers and 183 disclosed rate categories.

  • Rural referral center
  • Reclassified as rural
  • Disproportionate share hospital
  • 340B participant
  • ACO participant
  • Helipad
CCN
150012
NPI
1841245594
Website
sjmed.com
Health system
Trinity Health
Teaching
Teaching hospital
County
St. Joseph County
Metro area
South Bend-Mishawaka, IN-MI MSA
Medicare contractor
Jurisdiction 8, WPS Government Health Administrators (08001)
In Medicare since
1966
Last CMS survey
2017

Prices for common services

The 24 services Mishawaka Medical Center most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.

Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.

Childbirth · Inpatient

Vaginal delivery, hospital stay

MS-DRG 807

$11,228 - $12,265

from 2 insurers · median $11,747

UnitedHealthcare$11,228
Insurer A*$12,265

CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.

Hospital reports neonatal nursery services to CMS

Childbirth · Inpatient

Cesarean delivery, hospital stay

MS-DRG 788

$15,085 - $26,266

from 3 insurers · median $15,881

UnitedHealthcare$15,085
Insurer A*$15,881
Insurer B*$26,266

CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.

Hospital reports neonatal nursery services to CMS

Medicine & Surgery · Inpatient

Major cardiothoracic procedure with cardiac catheterization and MCC

MS-DRG 216

$167,770 - $268,000

from 3 insurers · median $169,832

Blue Cross$167,770
Insurer A*$169,832
Insurer B*$268,000
Medicare $90,833Nearby hospitals $158,8667% above nearby hospitals

Hospital reports cardiac thoracic surgery services to CMS

Childbirth · Inpatient

Vaginal birth after prior cesarean, hospital stay

MS-DRG 807

$11,228 - $12,265

from 2 insurers · median $11,747

UnitedHealthcare$11,228
Insurer A*$12,265

CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.

Hospital reports neonatal nursery services to CMS

How the insurers pay at Mishawaka Medical Center

Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.

InsurerServicesMedian % of MedicareAbove nearbyBelow nearby
Insurer A*24
334%
183
Insurer B*11
62%
011
Insurer C*4
-
20
Insurer D*6
-
20

How we chose these services: 7 appear in this hospital's own Medicare claims, 12 are common here based on CMS Medicare volume, and 5 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Mishawaka Medical Center, or start a free trial.

Insurance Accepted

Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.

Medicare
Aetna
BCBS
United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health)
Aspirus Health PlanAvera Health PlansBanner HealthCareSource (incl Common Ground Health Coop)EMI HealthGroup Health Cooperative of South Central Wisconsin

More about this hospital

  • Quality

    2 of 5 stars

    • 195 min in the ER before going home (US median 148)
    • Medicare readmissions penalty (-0.25%)
    See quality ratings
  • Doctors and services

    Accredited by The Joint Commission

    • Teaching hospital
    • 41 services
    • 522 affiliated clinicians
    See doctors and services
  • Finances

    $409.5M net patient revenue

    • Operating margin on patient care 2.7%
    • $12M unreimbursed and uncompensated care
    • $16.5M net income
    See finances
  • Ownership and leadership

    Owned by Saint Joseph Regional Medical Center Inc

    • Private (not for profit)
    • 340B drug pricing program participant
    See ownership and leadership

Tax IDs and NPIs insurers list

The employer identification numbers (EINs) health plans and networks list for Mishawaka Medical Center in the in-network rate files they publish, with the organization NPIs billed under each.

Tax ID (EIN)Plans and networks listing itOrganization NPIs
35-0868157(multi-state) Saint Joseph Regional Medical Center-South Bend Campus INC48Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter and 43 more1699132365 Saint Joseph Regional Medical Center-south Bend Campus Inc1841245594 Saint Joseph Regional Medical Center-south Bend Campus Inc.1780766261 Saint Joseph Regional Medical Center-south Bend Campus Inc.and 38 more

Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.

Location

5215 Holy Cross Parkway, Mishawaka, IN 46545

(574) 335-5000

Get directions

Frequently asked questions

About Mishawaka Medical Center's rates and hospital price transparency.

How much does an MRI cost at Mishawaka Medical Center?

For MRI brain before and after contrast (CPT 70553), published negotiated rates at Mishawaka Medical Center range from $257 to $1,339 across 2 insurers. Aetna's rate is $257. The median at nearby comparable hospitals is $1,001. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a CT scan cost at Mishawaka Medical Center?

For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Mishawaka Medical Center range from $353 to $1,339 across 2 insurers. Aetna's rate is $353. The median at nearby comparable hospitals is $1,312. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a colonoscopy cost at Mishawaka Medical Center?

For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Mishawaka Medical Center range from $505 to $3,978 across 2 insurers. Blue Cross Blue Shield's rate is $3,978. The median at nearby comparable hospitals is $1,883. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does giving birth cost at Mishawaka Medical Center?

For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Mishawaka Medical Center range from $11,228 to $12,265 across 2 insurers. UnitedHealthcare's rate is $11,228. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does hip or knee replacement cost at Mishawaka Medical Center?

For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Mishawaka Medical Center range from $28,425 to $52,842 across 3 insurers. Blue Cross Blue Shield's rate is $31,192. The median at nearby comparable hospitals is $27,285. What a patient pays depends on their plan's deductible, coinsurance and network status.

What is Mishawaka Medical Center's CMS star rating?

Mishawaka Medical Center has a CMS overall hospital star rating of 2 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 73% of US hospitals.

Is Mishawaka Medical Center a teaching hospital?

Yes. CMS counts 0.14 Medicare-funded residents per bed at Mishawaka Medical Center for fiscal year 2027, so it is a teaching hospital.

Does Medicare penalize Mishawaka Medical Center for readmissions?

Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Mishawaka Medical Center's base inpatient payments by an estimated 0.25% in fiscal year 2027 for more readmissions than expected.

What are the most common Medicare inpatient stays at Mishawaka Medical Center?

In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (218 discharges), heart failure and shock with mcc (107 discharges), acute myocardial infarction, discharged alive with mcc (69 discharges).

What is Mishawaka Medical Center's case mix index?

Mishawaka Medical Center's Medicare case mix index is 1.84 for fiscal year 2027, higher than 66% of hospitals paid under the inpatient prospective payment system.

For hospital finance and compliance teams

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The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.

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Publish a CMS-compliant machine-readable file

We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.

CMS v3 example: standard_charge_information[0]
{
  "description": "MRI of brain (no contrast)",
  "code_information": [
    { "code": "611", "type": "RC" },
    { "code": "70551", "type": "CPT" }
  ],
  "standard_charges": [{
    "setting": "outpatient",
    "minimum": 250,
    "maximum": 400,
    "gross_charge": 1200,
    "discounted_cash": 1080,
    "payers_information": [
      {
        "payer_name": "Platform Health Insurance",
        "plan_name": "PPO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 400
      },
      {
        "payer_name": "Region Health Insurance",
        "plan_name": "HMO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 250
      }
    ]
  }]
}
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  • cms-hpt.txt file and homepage footer link
  • Refreshed when your contracts change
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Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.

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CodingPricingPayer contractsCompliance
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  • Missing, duplicate and outdated charge lines identified
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