CMS Price Transparency Data

X-ray, hand

Facility: St Joseph's University Medical Center Inc

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $51
Cash Discount Price: $496
vs. Medicare Baseline: 0.57x Medicare

The contracted insurance negotiated median rate for a X-ray, hand 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 $496. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.57x the Medicare baseline. Located in 703 Main St, Paterson, NJ.

Cash / Self-Pay

$496

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

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $496 (558%)

Insurance Median: $51 (57%)

Cash: $496 (558% of Medicare)

Ins. Median: $51 (57% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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	$7 - $172	8%
UnitedHealthcare	$7 - $153	8%
Aetna	$9 - $211	10%
Ambetter / Centene	$9 - $155	10%
Amerihealth	$9 - $547	10%
Blue Cross Blue Shield	$9 - $294	10%
Clover Health	$9 - $103	10%
Horizon New Jersey Total Care	$9 - $103	10%
Wellpoint	$9 - $169	10%
Multiplan	$14 - $644	16%
Private Healthcare Systems	$19 - $558	21%
Horizon New Jersey Health	$25 - $110	28%
Cigna	$29 - $859	33%
Consumer Health Network	$40 - $773	45%
Longevity Health Plan	$119	134%
Oxford	$130	146%
Magnacare	$347 - $601	390%
Oscar	$467 - $809	525%

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 $496.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

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 73130.
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.