CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $99
  • Cash Discount Price: $9
  • vs. Medicare Baseline: 12.74x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Hackensack Meridian Mountainside Medical is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 12.74x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$9

Average discount available for prompt cash payment at this facility.

Insurance Median
$99

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$7.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $7.77 (100%)
Cash / Self-Pay: $9 (116%)
Insurance Median: $99 (1274%)
Cash: $9 (116% of Medicare)
Ins. Median: $99 (1274% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $7.77 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 1274% of the Medicare baseline (a markup of 1174%). 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] $12 - $99 154%
UnitedHealthcare $12 154%
Aetna $18 232%
Black Lung [6055] $48 618%
Create Flex / Select [3580] $48 618%
Healthcare Highways [2210] $48 - $99 618%
Lucent Health [6000] $48 618%
Medicare (plans) $48 618%
Oncology Patient Assistance Programs [2295] $48 618%
Selecthealth [3740] $48 618%
Web Tpa [2115] $48 618%
Worker'S Comp [2125] $48 - $109 618%
Wtc Healthcare Sme Karna [8005] $48 618%
First Health [1375] $88 - $99 1133%
Cigna $94 1210%
Administrative Concepts [1005] $99 1274%
Allied National Global Care [1035] $99 1274%
Gilsbar [1425] $99 1274%
Healthcost Solutions [2415] $99 1274%
Healthfirst [2395] $99 1274%
Healthnet [1495] $99 1274%
Hometown Health [2155] $99 1274%
Mayo Clinic Health Solutions [2280] $99 1274%
Multiplan [1680] $99 1274%
Mutual Of Omaha [1685] $99 1274%
New Era Life Insurance Company [1705] $99 1274%
Pan American Life Insurance Co [1770] $99 1274%
Pba [1775] $99 1274%
Phcs [1780] $99 1274%
Planned Administrators Inc [2360] $99 1274%
Resource One Administrators [2815] $99 1274%
Trustmark [2030] $99 1274%
Universal Fidelity [2085] $99 1274%
Emblem Health [2430] $109 1403%
Humana $109 1403%
Blue Cross Blue Shield $115 1480%
Amerihealth [3520] $117 1506%
Mva [1690] $117 1506%

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