CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: St Joseph's University Medical Center Inc

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $33,071
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.58x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at St Joseph's University Medical Center Inc is $33,071. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 2.58x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$33,071

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$12,807.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $12,807.1 (100%)
Insurance Median: $33,071 (258%)
Ins. Median: $33,071 (258% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $12,807.1 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 258% of the Medicare baseline (a markup of 158%). 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
Aetna $22,047 - $64,860 172%
Amerihealth $22,047 - $35,095 172%
Blue Cross Blue Shield $22,047 - $76,437 172%
Horizon New Jersey Total Care $22,047 172%
UnitedHealthcare $22,047 - $54,473 172%
Wellpoint $22,047 172%
Clover Health $22,378 175%
Fidelis Care of New Jersey $23,150 181%
Longevity Health Plan $25,354 198%
Ambetter / Centene $33,071 258%
Magnacare $40,667 318%
Oxford $50,182 392%

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