CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: St Joseph's University Medical Center Inc

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $51
  • Cash Discount Price: $253
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at St Joseph's University Medical Center Inc is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $253. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.56x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$253

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)
Cash / Self-Pay: $253 (773%)
Insurance Median: $51 (156%)
Cash: $253 (773% of Medicare)
Ins. Median: $51 (156% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $32.73 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 $27 - $51 82%
UnitedHealthcare $27 - $343 82%
Aetna $29 - $74 89%
Blue Cross Blue Shield $35 - $221 107%
Ambetter / Centene $36 - $54 110%
Amerihealth $36 - $161 110%
Clover Health $36 110%
Horizon New Jersey Total Care $36 110%
Wellpoint $36 - $50 110%
Longevity Health Plan $42 128%
Multiplan $54 - $190 165%
Horizon New Jersey Health $65 199%
Private Healthcare Systems $164 501%
Magnacare $177 541%
Consumer Health Network $228 697%
Oscar $238 727%
Cigna $253 773%
Oxford $316 965%

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