CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $275
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 20.54x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Hackensack Meridian Mountainside Medical is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 20.54x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$275

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$13.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13.39 (100%)
Cash / Self-Pay: $15 (112%)
Insurance Median: $275 (2054%)
Cash: $15 (112% of Medicare)
Ins. Median: $275 (2054% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $13.39 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 2054% of the Medicare baseline (a markup of 1954%). 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] $34 - $275 254%
UnitedHealthcare $34 254%
Aetna $50 373%
Black Lung [6055] $133 993%
Create Flex / Select [3580] $133 993%
Healthcare Highways [2210] $133 - $275 993%
Lucent Health [6000] $133 993%
Medicare (plans) $133 993%
Oncology Patient Assistance Programs [2295] $133 993%
Selecthealth [3740] $133 993%
Web Tpa [2115] $133 993%
Worker'S Comp [2125] $133 - $301 993%
Wtc Healthcare Sme Karna [8005] $133 993%
First Health [1375] $243 - $275 1815%
Cigna $259 1934%
Administrative Concepts [1005] $275 2054%
Allied National Global Care [1035] $275 2054%
Gilsbar [1425] $275 2054%
Healthcost Solutions [2415] $275 2054%
Healthfirst [2395] $275 2054%
Healthnet [1495] $275 2054%
Hometown Health [2155] $275 2054%
Mayo Clinic Health Solutions [2280] $275 2054%
Multiplan [1680] $275 2054%
Mutual Of Omaha [1685] $275 2054%
New Era Life Insurance Company [1705] $275 2054%
Pan American Life Insurance Co [1770] $275 2054%
Pba [1775] $275 2054%
Phcs [1780] $275 2054%
Planned Administrators Inc [2360] $275 2054%
Resource One Administrators [2815] $275 2054%
Trustmark [2030] $275 2054%
Universal Fidelity [2085] $275 2054%
Emblem Health [2430] $301 2248%
Humana $301 2248%
Blue Cross Blue Shield $319 2382%
Amerihealth [3520] $324 2420%
Mva [1690] $324 2420%

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