CMS Price Transparency Data

Mental health services (assessment)

Facility: St Joseph's University Medical Center Inc

Billing Code: H0031 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: H0031
Insurance Median: $53
Cash Discount Price: $112
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Mental health services (assessment) at St Joseph's University Medical Center Inc is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 703 Main St, Paterson, NJ.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$20 - $72	N/A
Amerihealth	$22 - $71	N/A
Fidelis Care of New Jersey	$22 - $33	N/A
Wellpoint	$22	N/A
Aetna	$23 - $56	N/A
Blue Cross Blue Shield	$24 - $98	N/A
Ambetter / Centene	$34	N/A
Horizon New Jersey Health	$35	N/A
Oxford	$72	N/A
Private Healthcare Systems	$73	N/A
Magnacare	$78	N/A
Multiplan	$84	N/A
Consumer Health Network	$101	N/A
Longevity Health Plan	$101	N/A
Oscar	$106	N/A
Cigna	$112	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $112.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: H0031.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Joseph's University Medical Center Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code H0031.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.