CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: St Joseph's University Medical Center Inc

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $46
  • Cash Discount Price: $257
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at St Joseph's University Medical Center Inc is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.66x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$257

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$27.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $27.72 (100%)
Cash / Self-Pay: $257 (927%)
Insurance Median: $46 (166%)
Cash: $257 (927% of Medicare)
Ins. Median: $46 (166% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $27.72 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 $23 - $51 83%
UnitedHealthcare $23 - $343 83%
Aetna $26 - $63 94%
Ambetter / Centene $31 - $46 112%
Amerihealth $31 - $164 112%
Blue Cross Blue Shield $31 - $224 112%
Clover Health $31 112%
Horizon New Jersey Total Care $31 112%
Wellpoint $31 - $50 112%
Longevity Health Plan $35 126%
Multiplan $46 - $193 166%
Horizon New Jersey Health $65 234%
Private Healthcare Systems $167 602%
Magnacare $180 649%
Consumer Health Network $231 833%
Oscar $242 873%
Cigna $257 927%
Oxford $316 1140%

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