CMS Price Transparency Data

Blood antibody screen

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $179
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 3.36x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Hackensack Meridian Mountainside Medical is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 3.36x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$179

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)
Cash / Self-Pay: $69 (130%)
Insurance Median: $179 (336%)
Cash: $69 (130% of Medicare)
Ins. Median: $179 (336% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 336% of the Medicare baseline (a markup of 236%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Healthscope Benefits [2290] $22 - $178 41%
UnitedHealthcare $22 41%
Aetna $32 60%
Black Lung [6055] $86 162%
Create Flex / Select [3580] $86 162%
Healthcare Highways [2210] $86 - $178 162%
Lucent Health [6000] $86 162%
Medicare (plans) $86 162%
Oncology Patient Assistance Programs [2295] $86 162%
Selecthealth [3740] $86 162%
Web Tpa [2115] $86 162%
Worker'S Comp [2125] $86 - $195 162%
Wtc Healthcare Sme Karna [8005] $86 162%
First Health [1375] $158 - $178 297%
Cigna $168 316%
Administrative Concepts [1005] $178 334%
Allied National Global Care [1035] $178 334%
Gilsbar [1425] $178 334%
Healthcost Solutions [2415] $178 334%
Healthfirst [2395] $178 334%
Healthnet [1495] $178 334%
Hometown Health [2155] $178 334%
Mayo Clinic Health Solutions [2280] $178 334%
Multiplan [1680] $178 334%
Mutual Of Omaha [1685] $178 334%
New Era Life Insurance Company [1705] $178 334%
Pan American Life Insurance Co [1770] $178 334%
Pba [1775] $178 334%
Phcs [1780] $178 334%
Planned Administrators Inc [2360] $178 334%
Resource One Administrators [2815] $178 334%
Trustmark [2030] $178 334%
Universal Fidelity [2085] $178 334%
Emblem Health [2430] $195 366%
Humana $195 366%
Amerihealth [3520] $210 394%
Mva [1690] $210 394%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Bay Avenue, Montclair, NJ 07042
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals