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Short Term Acute Care HospitalVoluntary Non-Profit - Church

Plymouth Medical Center

Trinity Health · Plymouth, IN

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

4 of 5

CMS star rating

30

Beds

978

Inpatient discharges a year

$53.1M

Net patient revenue a year

23

In-network payers

About this hospital

Plymouth Medical Center is a 30-bed voluntary non-profit - church hospital in Plymouth, IN, affiliated with Trinity Health. Below you'll find publicly disclosed negotiated rates and facility details, including 23 in-network payers and 164 disclosed rate categories.

  • ACO participant
CCN
150076
NPI
1174571129
Website
sjmed.com
Health system
Trinity Health
Teaching
No Medicare-funded residents
County
Marshall County
Metro area
Plymouth, IN MicroSA
Medicare contractor
Jurisdiction 8, WPS Government Health Administrators (08001)
In Medicare since
1966
Last CMS survey
2003

Prices for common services

The 24 services Plymouth 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

$10,713 - $19,523

from 3 insurers · median $11,228

UnitedHealthcare$11,228
Insurer A*$10,713
Insurer B*$19,523

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

$14,539 - $15,085

from 2 insurers · median $14,812

UnitedHealthcare$15,085
Insurer A*$14,539

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

Cataract removal with lens insertion

CPT 66984

$758 - $8,549

from 2 insurers · median $4,654

Blue Cross$8,549
Insurer A*$758
Medicare $2,231Nearby hospitals $3,46134% above nearby hospitals

73 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)

Childbirth · Inpatient

Vaginal birth after prior cesarean, hospital stay

MS-DRG 807

$10,713 - $19,523

from 3 insurers · median $11,228

UnitedHealthcare$11,228
Insurer A*$10,713
Insurer B*$19,523

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 Plymouth 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*22
342%
143
Insurer B*9
319%
00
Insurer C*12
91%
38
Insurer D*7
-
00

How we chose these services: 3 appear in this hospital's own Medicare claims, 11 are common here based on CMS Medicare volume, and 10 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 Plymouth 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)
Ameri HealthAspirus Health PlanAvera Health PlansBanner HealthCareSource (incl Common Ground Health Coop)EMI Health

More about this hospital

  • Quality

    4 of 5 stars

    • 138 min in the ER before going home (US median 148)
    • Medicare readmissions penalty (-0.01%)
    See quality ratings
  • Doctors and services

    Accredited by The Joint Commission

    • No Medicare-funded residents
    • 30 services
    • 240 affiliated clinicians
    See doctors and services
  • Finances

    $53.1M net patient revenue

    • Operating margin on patient care -3.8%
    • $2.4M unreimbursed and uncompensated care
    • -$1.1M net income
    See finances
  • Ownership and leadership

    Owned by Saint Joseph Regional Medical Center Inc

    • Church
    See ownership and leadership

Tax IDs and NPIs insurers list

The employer identification numbers (EINs) health plans and networks list for Plymouth 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
35-1142669(multi-state) Saint Joseph Regional Medical Center-Plymouth Campus INC43Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter and 38 more1174571129 Saint Joseph Regional Medical Center- Plymouth Campus Inc1821402876 Saint Joseph Regional Medical Center- Plymouth Campus Inc1538585187 Saint Joseph Regional Medical Center- Plymouth Campus Incand 1 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

1915 Lake Avenue, Plymouth, IN 46563

(574) 948-4000

Get directions

Frequently asked questions

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

How much does an MRI cost at Plymouth Medical Center?

For MRI brain before and after contrast (CPT 70553), published negotiated rates at Plymouth Medical Center range from $426 to $1,205 across 2 insurers. Aetna's rate is $426. The median at nearby comparable hospitals is $611. What a patient pays depends on their plan's deductible, coinsurance and network status.

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

For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Plymouth Medical Center range from $416 to $1,205 across 2 insurers. Aetna's rate is $416. The median at nearby comparable hospitals is $602. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a colonoscopy cost at Plymouth Medical Center?

For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Plymouth Medical Center range from $808 to $3,978 across 2 insurers. Blue Cross Blue Shield's rate is $3,978. The median at nearby comparable hospitals is $2,187. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does giving birth cost at Plymouth Medical Center?

For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Plymouth Medical Center range from $10,713 to $19,523 across 3 insurers. UnitedHealthcare's rate is $11,228. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a mammogram cost at Plymouth Medical Center?

For Screening mammography, bilateral (CPT 77067), published negotiated rates at Plymouth Medical Center range from $184 to $268 across 2 insurers. Cigna's rate is $268. The median at nearby comparable hospitals is $235. What a patient pays depends on their plan's deductible, coinsurance and network status.

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

For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Plymouth Medical Center range from $31,864 to $55,856 across 3 insurers. Blue Cross Blue Shield's rate is $31,864. The median at nearby comparable hospitals is $25,627. What a patient pays depends on their plan's deductible, coinsurance and network status.

What is Plymouth Medical Center's CMS star rating?

Plymouth Medical Center has a CMS overall hospital star rating of 4 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is higher than 58% of US hospitals.

Is Plymouth Medical Center a teaching hospital?

CMS reports no Medicare-funded interns or residents at Plymouth Medical Center for fiscal year 2027.

Does Medicare penalize Plymouth Medical Center for readmissions?

Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Plymouth Medical Center's base inpatient payments by an estimated 0.01% in fiscal year 2027 for more readmissions than expected.

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

In 2024, the most common were heart failure and shock with mcc (43 discharges), simple pneumonia and pleurisy with mcc (19 discharges), septicemia or severe sepsis without mv >96 hours with mcc (18 discharges).

For hospital finance and compliance teams

Running price transparency at a hospital like this one?

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.

Compliance MRF

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
      }
    ]
  }]
}
  • CMS template layout, in JSON or CSV
  • Gross, discounted cash, payer-specific and de-identified min / max charges
  • cms-hpt.txt file and homepage footer link
  • Refreshed when your contracts change
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Chargemaster analysis

Get your chargemaster right for billing and payer contracts

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.

What a review covers

CodingPricingPayer contractsCompliance
  • CPT, HCPCS, revenue code and modifier errors flagged line by line
  • Missing, duplicate and outdated charge lines identified
  • Charges set below payer allowables caught before lesser-of clauses cut payment
  • Revenue impact of charge changes modeled across percent-of-charge and stop-loss terms
  • Your negotiated rates benchmarked against peer hospitals for the same payers
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