CMS Price Transparency Data

Orthotic fitting and training

Facility: St Joseph's University Medical Center Inc

Billing Code: 97760 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97760
  • Insurance Median: $65
  • Cash Discount Price: $219
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Orthotic fitting and training at St Joseph's University Medical Center Inc is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $219. Compared to the federal Medicare reimbursement reference rate of $46.09, this hospital’s rate is 1.41x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$219

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$46.09

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $46.09 (100%)
Cash / Self-Pay: $219 (475%)
Insurance Median: $65 (141%)
Cash: $219 (475% of Medicare)
Ins. Median: $65 (141% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $46.09 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
Aetna $33 - $106 72%
UnitedHealthcare $37 - $343 80%
Fidelis Care of New Jersey $39 - $54 85%
Blue Cross Blue Shield $40 - $200 87%
Wellpoint $41 - $52 89%
Ambetter / Centene $52 - $78 113%
Amerihealth $52 - $146 113%
Clover Health $52 113%
Horizon New Jersey Total Care $52 113%
Longevity Health Plan $60 130%
Horizon New Jersey Health $65 141%
Multiplan $78 - $172 169%
Private Healthcare Systems $135 - $149 293%
Magnacare $146 - $160 317%
Consumer Health Network $187 - $206 406%
Oscar $196 - $216 425%
Cigna $208 - $229 451%
Oxford $316 686%

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