CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: St Joseph's University Medical Center Inc

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $132
Cash Discount Price: $1,514
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at St Joseph's University Medical Center Inc is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,514. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.24x the Medicare baseline. Located in 703 Main St, Paterson, NJ.

Cash / Self-Pay

$1,514

Average discount available for prompt cash payment at this facility.

Insurance Median

$132

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $1,514 (1417%)

Insurance Median: $132 (124%)

Cash: $1,514 (1417% of Medicare)

Ins. Median: $132 (124% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$31 - $303	29%
UnitedHealthcare	$31 - $970	29%
Aetna	$41 - $757	38%
Ambetter / Centene	$41 - $186	38%
Amerihealth	$41 - $964	38%
Clover Health	$41 - $130	38%
Horizon New Jersey Total Care	$41 - $130	38%
Wellpoint	$41 - $297	38%
Blue Cross Blue Shield	$44 - $354	41%
Multiplan	$61 - $1,136	57%
Horizon New Jersey Health	$108 - $469	101%
Longevity Health Plan	$143	134%
Oxford	$160 - $970	150%
Consumer Health Network	$170 - $1,363	159%
Private Healthcare Systems	$259 - $984	242%
Cigna	$399 - $1,514	374%
Magnacare	$1,060	992%
Oscar	$1,426	1335%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,514.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76700.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Joseph's University Medical Center Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76700.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.