CMS Price Transparency Data

Blood test, sodium

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $58
  • Cash Discount Price: $6
  • vs. Medicare Baseline: 12.06x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Hackensack Meridian Mountainside Medical is $58. 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 $4.81, this hospital’s rate is 12.06x 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
$58

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)
Cash / Self-Pay: $6 (125%)
Insurance Median: $58 (1206%)
Cash: $6 (125% of Medicare)
Ins. Median: $58 (1206% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.81 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 1206% of the Medicare baseline (a markup of 1106%). 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] $7 - $58 146%
UnitedHealthcare $7 146%
Aetna $10 208%
Black Lung [6055] $28 582%
Create Flex / Select [3580] $28 582%
Healthcare Highways [2210] $28 - $58 582%
Lucent Health [6000] $28 582%
Medicare (plans) $28 582%
Oncology Patient Assistance Programs [2295] $28 582%
Selecthealth [3740] $28 582%
Web Tpa [2115] $28 582%
Worker'S Comp [2125] $28 582%
Wtc Healthcare Sme Karna [8005] $28 582%
First Health [1375] $51 - $58 1060%
Administrative Concepts [1005] $58 1206%
Allied National Global Care [1035] $58 1206%
Gilsbar [1425] $58 1206%
Healthcost Solutions [2415] $58 1206%
Healthfirst [2395] $58 1206%
Healthnet [1495] $58 1206%
Hometown Health [2155] $58 1206%
Mayo Clinic Health Solutions [2280] $58 1206%
Multiplan [1680] $58 1206%
Mutual Of Omaha [1685] $58 1206%
New Era Life Insurance Company [1705] $58 1206%
Pan American Life Insurance Co [1770] $58 1206%
Pba [1775] $58 1206%
Phcs [1780] $58 1206%
Planned Administrators Inc [2360] $58 1206%
Resource One Administrators [2815] $58 1206%
Trustmark [2030] $58 1206%
Universal Fidelity [2085] $58 1206%
Amerihealth [3520] $68 1414%
Mva [1690] $68 1414%

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