CMS Price Transparency Data

Blood test, liver function panel

Facility: St Joseph's University Medical Center Inc

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $17
  • Cash Discount Price: $174
  • vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at St Joseph's University Medical Center Inc is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 2.08x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$174

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)
Cash / Self-Pay: $174 (2130%)
Insurance Median: $17 (208%)
Cash: $174 (2130% of Medicare)
Ins. Median: $17 (208% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.17 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 208% of the Medicare baseline (a markup of 108%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

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

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
UnitedHealthcare $7 - $17 86%
Wellpoint $7 - $8 86%
Aetna $8 - $36 98%
Amerihealth $8 - $111 98%
Blue Cross Blue Shield $8 - $152 98%
Clover Health $8 98%
Horizon New Jersey Total Care $8 98%
Fidelis Care of New Jersey $9 - $35 110%
Longevity Health Plan $9 110%
Horizon New Jersey Health $11 135%
Ambetter / Centene $12 147%
Oxford $17 208%
Private Healthcare Systems $113 1383%
Magnacare $122 1493%
Multiplan $130 1591%
Consumer Health Network $157 1922%
Oscar $164 2007%
Cigna $174 2130%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 703 Main St, Paterson, NJ 07503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals