CMS Price Transparency Data

Electrical stimulation therapy

Facility: St Mary's General Hospital

Billing Code: G0283 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0283
  • Insurance Median: $28
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 2.21x Medicare
The contracted insurance negotiated median rate for a Electrical stimulation therapy at St Mary's General Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $12.69, this hospital’s rate is 2.21x the Medicare baseline. Located in 350 Boulevard, Passaic, NJ.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$12.69

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $12.69 (100%)
Cash / Self-Pay: $14 (110%)
Insurance Median: $28 (221%)
Cash: $14 (110% of Medicare)
Ins. Median: $28 (221% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $12.69 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 221% of the Medicare baseline (a markup of 121%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Humana $11 87%
Aetna $14 - $30 110%
Wellcare $14 - $19 110%
Amerihealth $14 110%
Horizon $14 - $114 110%
Wellpoint Amerigroup $14 110%
Medicare (plans) $14 110%
UnitedHealthcare $14 - $162 110%
Clover Health $14 110%
Tricare $14 110%
Ally-Align (Fka Spartan Plan Nj, Inc.) $15 118%
Employer Direct Healthcare $20 158%
Cigna $22 173%
Fairprice Healthcare Holdings $23 181%
Coventry $28 221%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 350 Boulevard, Passaic, NJ 07055
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals