CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: St Joseph's University Medical Center Inc

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $48
  • Cash Discount Price: $373
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at St Joseph's University Medical Center Inc is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $373. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.65x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$373

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $373 (1284%)
Insurance Median: $48 (165%)
Cash: $373 (1284% of Medicare)
Ins. Median: $48 (165% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $29.06 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 $24 - $75 83%
UnitedHealthcare $24 - $343 83%
Aetna $28 - $77 96%
Ambetter / Centene $32 - $48 110%
Amerihealth $32 - $237 110%
Blue Cross Blue Shield $32 - $325 110%
Clover Health $32 110%
Horizon New Jersey Total Care $32 110%
Wellpoint $32 - $73 110%
Longevity Health Plan $37 127%
Multiplan $48 - $280 165%
Horizon New Jersey Health $65 224%
Private Healthcare Systems $242 833%
Magnacare $261 898%
Oxford $316 1087%
Consumer Health Network $336 1156%
Oscar $351 1208%
Cigna $373 1284%

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