CMS Price Transparency Data

Culture, bacterial

Facility: St Joseph's University Medical Center Inc

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $19
  • Cash Discount Price: $153
  • vs. Medicare Baseline: 2.20x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at St Joseph's University Medical Center Inc is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $153. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 2.20x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$153

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.62

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.62 (100%)
Cash / Self-Pay: $153 (1775%)
Insurance Median: $19 (220%)
Cash: $153 (1775% of Medicare)
Ins. Median: $19 (220% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.62 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 220% of the Medicare baseline (a markup of 120%). 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 $8 - $18 93%
Aetna $9 - $31 104%
Amerihealth $9 - $97 104%
Blue Cross Blue Shield $9 - $133 104%
Clover Health $9 104%
Fidelis Care of New Jersey $9 - $31 104%
Horizon New Jersey Total Care $9 104%
Wellpoint $9 104%
Longevity Health Plan $10 116%
Ambetter / Centene $13 151%
Horizon New Jersey Health $14 - $32 162%
Oxford $18 209%
Consumer Health Network $19 - $138 220%
Multiplan $25 - $115 290%
Private Healthcare Systems $25 - $99 290%
Cigna $38 - $153 441%
Magnacare $107 1241%
Oscar $144 1671%

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