CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St Joseph's University Medical Center Inc

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $414
  • Cash Discount Price: $5,662
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St Joseph's University Medical Center Inc is $414. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,662. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.16x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$5,662

Average discount available for prompt cash payment at this facility.

Insurance Median
$414

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $5,662 (1589%)
Insurance Median: $414 (116%)
Cash: $5,662 (1589% of Medicare)
Ins. Median: $414 (116% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 $86 - $1,133 24%
UnitedHealthcare $86 - $1,006 24%
Aetna $114 - $2,112 32%
Ambetter / Centene $114 - $622 32%
Amerihealth $114 - $3,605 32%
Clover Health $114 - $414 32%
Horizon New Jersey Total Care $114 - $414 32%
Wellpoint $114 - $1,112 32%
Blue Cross Blue Shield $129 - $1,349 36%
Multiplan $172 - $4,246 48%
Longevity Health Plan $477 134%
Oxford $553 155%
Consumer Health Network $721 - $5,096 202%
Horizon New Jersey Health $887 249%
Private Healthcare Systems $3,680 1032%
Magnacare $3,963 1112%
Oscar $5,334 1497%
Cigna $5,662 1589%

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