CMS Price Transparency Data

CT scan, sinuses

Facility: St Joseph's University Medical Center Inc

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $146
  • Cash Discount Price: $3,224
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at St Joseph's University Medical Center Inc is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,224. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.37x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$3,224

Average discount available for prompt cash payment at this facility.

Insurance Median
$146

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $3,224 (3018%)
Insurance Median: $146 (137%)
Cash: $3,224 (3018% of Medicare)
Ins. Median: $146 (137% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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.

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
Fidelis Care of New Jersey $32 - $645 30%
UnitedHealthcare $32 - $573 30%
Aetna $43 - $663 40%
Ambetter / Centene $43 - $186 40%
Amerihealth $43 - $2,053 40%
Clover Health $43 - $146 40%
Horizon New Jersey Total Care $43 - $146 40%
Wellpoint $43 - $633 40%
Blue Cross Blue Shield $62 - $486 58%
Multiplan $65 - $2,418 61%
Longevity Health Plan $143 134%
Oxford $160 150%
Horizon New Jersey Health $224 210%
Consumer Health Network $386 - $2,902 361%
Private Healthcare Systems $2,096 1962%
Magnacare $2,257 2113%
Oscar $3,037 2843%
Cigna $3,224 3018%

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