CMS Price Transparency Data

Prosthetic fitting and training

Facility: St Joseph's University Medical Center Inc

Billing Code: 97761 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97761
  • Insurance Median: $53
  • Cash Discount Price: $200
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Prosthetic fitting and training at St Joseph's University Medical Center Inc is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $40.41, this hospital’s rate is 1.31x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$200

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$40.41

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $40.41 (100%)
Cash / Self-Pay: $200 (495%)
Insurance Median: $53 (131%)
Cash: $200 (495% of Medicare)
Ins. Median: $53 (131% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $40.41 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 $29 - $92 72%
Fidelis Care of New Jersey $34 - $47 84%
UnitedHealthcare $34 - $343 84%
Blue Cross Blue Shield $35 - $174 87%
Wellpoint $39 - $45 97%
Ambetter / Centene $45 - $68 111%
Amerihealth $45 - $127 111%
Clover Health $45 111%
Horizon New Jersey Total Care $45 111%
Longevity Health Plan $52 129%
Horizon New Jersey Health $65 161%
Multiplan $68 - $150 168%
Private Healthcare Systems $130 322%
Magnacare $140 346%
Consumer Health Network $180 445%
Oscar $188 465%
Cigna $200 495%
Oxford $316 782%

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