CMS Price Transparency Data

X-ray, lower back

Facility: St Joseph's University Medical Center Inc

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $70
Cash Discount Price: $406
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at St Joseph's University Medical Center Inc is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $406. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.66x the Medicare baseline. Located in 703 Main St, Paterson, NJ.

Cash / Self-Pay

$406

Average discount available for prompt cash payment at this facility.

Insurance Median

$70

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: $406 (380%)

Insurance Median: $70 (66%)

Cash: $406 (380% of Medicare)

Ins. Median: $70 (66% 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	$10 - $152	9%
UnitedHealthcare	$10 - $160	9%
Aetna	$14 - $253	13%
Ambetter / Centene	$14 - $186	13%
Amerihealth	$14 - $483	13%
Clover Health	$14 - $124	13%
Horizon New Jersey Total Care	$14 - $124	13%
Wellpoint	$14 - $149	13%
Blue Cross Blue Shield	$17 - $354	16%
Multiplan	$21 - $569	20%
Private Healthcare Systems	$34 - $493	32%
Horizon New Jersey Health	$44 - $45	41%
Cigna	$52 - $759	49%
Consumer Health Network	$70 - $683	66%
Longevity Health Plan	$143	134%
Oxford	$160	150%
Magnacare	$531	497%
Oscar	$715	669%

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 $406.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72110.

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 72110.
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.