CMS Price Transparency Data

Blood test, liver function panel

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $159
  • Cash Discount Price: $9
  • vs. Medicare Baseline: 19.46x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Hackensack Meridian Mountainside Medical is $159. 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 $8.17, this hospital’s rate is 19.46x 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
$159

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)
Cash / Self-Pay: $9 (110%)
Insurance Median: $159 (1946%)
Cash: $9 (110% of Medicare)
Ins. Median: $159 (1946% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.17 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 1946% of the Medicare baseline (a markup of 1846%). 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] $20 - $159 245%
UnitedHealthcare $20 245%
Aetna $29 355%
Black Lung [6055] $77 942%
Create Flex / Select [3580] $77 942%
Healthcare Highways [2210] $77 - $159 942%
Lucent Health [6000] $77 942%
Medicare (plans) $77 942%
Oncology Patient Assistance Programs [2295] $77 942%
Selecthealth [3740] $77 942%
Web Tpa [2115] $77 942%
Worker'S Comp [2125] $77 - $174 942%
Wtc Healthcare Sme Karna [8005] $77 942%
First Health [1375] $140 - $159 1714%
Cigna $150 1836%
Administrative Concepts [1005] $159 1946%
Allied National Global Care [1035] $159 1946%
Gilsbar [1425] $159 1946%
Healthcost Solutions [2415] $159 1946%
Healthfirst [2395] $159 1946%
Healthnet [1495] $159 1946%
Hometown Health [2155] $159 1946%
Mayo Clinic Health Solutions [2280] $159 1946%
Multiplan [1680] $159 1946%
Mutual Of Omaha [1685] $159 1946%
New Era Life Insurance Company [1705] $159 1946%
Pan American Life Insurance Co [1770] $159 1946%
Pba [1775] $159 1946%
Phcs [1780] $159 1946%
Planned Administrators Inc [2360] $159 1946%
Resource One Administrators [2815] $159 1946%
Trustmark [2030] $159 1946%
Universal Fidelity [2085] $159 1946%
Emblem Health [2430] $174 2130%
Humana $174 2130%
Blue Cross Blue Shield $184 2252%
Amerihealth [3520] $187 2289%
Mva [1690] $187 2289%

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