CMS Price Transparency Data

Blood test, hemoglobin

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $42
  • Cash Discount Price: $3
  • vs. Medicare Baseline: 17.72x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Hackensack Meridian Mountainside Medical is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 17.72x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$3

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2.37

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2.37 (100%)
Cash / Self-Pay: $3 (127%)
Insurance Median: $42 (1772%)
Cash: $3 (127% of Medicare)
Ins. Median: $42 (1772% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2.37 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 1772% of the Medicare baseline (a markup of 1672%). 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] $5 - $42 211%
UnitedHealthcare $5 211%
Aetna $8 338%
Black Lung [6055] $20 844%
Create Flex / Select [3580] $20 844%
Healthcare Highways [2210] $20 - $42 844%
Lucent Health [6000] $20 844%
Medicare (plans) $20 844%
Oncology Patient Assistance Programs [2295] $20 844%
Selecthealth [3740] $20 844%
Web Tpa [2115] $20 844%
Worker'S Comp [2125] $20 844%
Wtc Healthcare Sme Karna [8005] $20 844%
First Health [1375] $37 - $42 1561%
Administrative Concepts [1005] $42 1772%
Allied National Global Care [1035] $42 1772%
Gilsbar [1425] $42 1772%
Healthcost Solutions [2415] $42 1772%
Healthfirst [2395] $42 1772%
Healthnet [1495] $42 1772%
Hometown Health [2155] $42 1772%
Mayo Clinic Health Solutions [2280] $42 1772%
Multiplan [1680] $42 1772%
Mutual Of Omaha [1685] $42 1772%
New Era Life Insurance Company [1705] $42 1772%
Pan American Life Insurance Co [1770] $42 1772%
Pba [1775] $42 1772%
Phcs [1780] $42 1772%
Planned Administrators Inc [2360] $42 1772%
Resource One Administrators [2815] $42 1772%
Trustmark [2030] $42 1772%
Universal Fidelity [2085] $42 1772%
Amerihealth [3520] $49 2068%
Mva [1690] $49 2068%

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