CMS Price Transparency Data

Vaginal delivery (full package)

Facility: St Joseph's University Medical Center Inc

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $3,442
Cash Discount Price: $25,116
vs. Medicare Baseline: 1.55x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at St Joseph's University Medical Center Inc is $3,442. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,116. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.55x the Medicare baseline. Located in 703 Main St, Paterson, NJ.

Cash / Self-Pay

$25,116

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,442

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$2,214.42

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,214.42 (100%)

Cash / Self-Pay: $25,116 (1134%)

Insurance Median: $3,442 (155%)

Cash: $25,116 (1134% of Medicare)

Ins. Median: $3,442 (155% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2,214.42 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
Aetna	$1,112 - $12,558	50%
UnitedHealthcare	$1,712 - $4,463	77%
Oxford	$1,770 - $3,500	80%
Fidelis Care of New Jersey	$1,812 - $5,026	82%
Blue Cross Blue Shield	$2,109 - $6,881	95%
Ambetter / Centene	$2,417 - $3,625	109%
Amerihealth	$2,417 - $15,991	109%
Clover Health	$2,417	109%
Horizon New Jersey Total Care	$2,417	109%
Wellpoint	$2,417 - $4,933	109%
Longevity Health Plan	$2,779	125%
Consumer Health Network	$3,607 - $22,604	163%
Multiplan	$3,625 - $18,837	164%
Private Healthcare Systems	$5,042 - $16,325	228%
Horizon New Jersey Health	$6,594 - $7,786	298%
Cigna	$7,757 - $25,116	350%
Magnacare	$17,581	794%
Oscar	$23,659	1068%

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 $25,116.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 59400.

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 59400.
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.