CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $73
  • Cash Discount Price: $6
  • vs. Medicare Baseline: 14.26x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Hackensack Meridian Mountainside Medical is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 14.26x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$6

Average discount available for prompt cash payment at this facility.

Insurance Median
$73

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5.12

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5.12 (100%)
Cash / Self-Pay: $6 (117%)
Insurance Median: $73 (1426%)
Cash: $6 (117% of Medicare)
Ins. Median: $73 (1426% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5.12 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 1426% of the Medicare baseline (a markup of 1326%). 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] $9 - $73 176%
UnitedHealthcare $9 176%
Aetna $13 254%
Black Lung [6055] $35 684%
Create Flex / Select [3580] $35 684%
Healthcare Highways [2210] $35 - $73 684%
Lucent Health [6000] $35 684%
Medicare (plans) $35 684%
Oncology Patient Assistance Programs [2295] $35 684%
Selecthealth [3740] $35 684%
Web Tpa [2115] $35 684%
Worker'S Comp [2125] $35 684%
Wtc Healthcare Sme Karna [8005] $35 684%
First Health [1375] $65 - $73 1270%
Administrative Concepts [1005] $73 1426%
Allied National Global Care [1035] $73 1426%
Gilsbar [1425] $73 1426%
Healthcost Solutions [2415] $73 1426%
Healthfirst [2395] $73 1426%
Healthnet [1495] $73 1426%
Hometown Health [2155] $73 1426%
Mayo Clinic Health Solutions [2280] $73 1426%
Multiplan [1680] $73 1426%
Mutual Of Omaha [1685] $73 1426%
New Era Life Insurance Company [1705] $73 1426%
Pan American Life Insurance Co [1770] $73 1426%
Pba [1775] $73 1426%
Phcs [1780] $73 1426%
Planned Administrators Inc [2360] $73 1426%
Resource One Administrators [2815] $73 1426%
Trustmark [2030] $73 1426%
Universal Fidelity [2085] $73 1426%
Amerihealth [3520] $86 1680%
Mva [1690] $86 1680%

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