CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: St Joseph's University Medical Center Inc

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $139
  • Cash Discount Price: $457
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at St Joseph's University Medical Center Inc is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $457. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.18x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$457

Average discount available for prompt cash payment at this facility.

Insurance Median
$139

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $457 (389%)
Insurance Median: $139 (118%)
Cash: $457 (389% of Medicare)
Ins. Median: $139 (118% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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 $58 - $137 49%
UnitedHealthcare $58 - $353 49%
Aetna $75 - $276 64%
Ambetter / Centene $77 - $196 65%
Amerihealth $77 - $351 65%
Clover Health $77 - $131 65%
Horizon New Jersey Total Care $77 - $131 65%
Wellpoint $77 - $131 65%
Private Healthcare Systems $91 - $358 77%
Amerihealth Behavioral Health $102 87%
Blue Cross Blue Shield $116 - $372 99%
Multiplan $116 - $413 99%
Oxford $116 - $353 99%
Horizon New Jersey Health $119 - $309 101%
Cigna $140 - $551 119%
Longevity Health Plan $150 128%
Consumer Health Network $156 - $496 133%
Magnacare $386 328%
Oscar $519 441%

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