CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,252
  • Cash Discount Price: $137
  • vs. Medicare Baseline: 11.72x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Hackensack Meridian Mountainside Medical is $1,252. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $137. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.72x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$137

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,252

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $137 (128%)
Insurance Median: $1,252 (1172%)
Cash: $137 (128% of Medicare)
Ins. Median: $1,252 (1172% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 1172% of the Medicare baseline (a markup of 1072%). 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] $155 - $1,252 145%
UnitedHealthcare $155 145%
Aetna $225 211%
Black Lung [6055] $604 565%
Create Flex / Select [3580] $604 565%
Healthcare Highways [2210] $604 - $1,252 565%
Lucent Health [6000] $604 565%
Medicare (plans) $604 565%
Oncology Patient Assistance Programs [2295] $604 565%
Selecthealth [3740] $604 565%
Web Tpa [2115] $604 565%
Worker'S Comp [2125] $604 - $1,368 565%
Wtc Healthcare Sme Karna [8005] $604 565%
First Health [1375] $1,105 - $1,252 1035%
Cigna $1,178 1103%
Administrative Concepts [1005] $1,252 1172%
Allied National Global Care [1035] $1,252 1172%
Gilsbar [1425] $1,252 1172%
Healthcost Solutions [2415] $1,252 1172%
Healthfirst [2395] $1,252 1172%
Healthnet [1495] $1,252 1172%
Hometown Health [2155] $1,252 1172%
Mayo Clinic Health Solutions [2280] $1,252 1172%
Multiplan [1680] $1,252 1172%
Mutual Of Omaha [1685] $1,252 1172%
New Era Life Insurance Company [1705] $1,252 1172%
Pan American Life Insurance Co [1770] $1,252 1172%
Pba [1775] $1,252 1172%
Phcs [1780] $1,252 1172%
Planned Administrators Inc [2360] $1,252 1172%
Resource One Administrators [2815] $1,252 1172%
Trustmark [2030] $1,252 1172%
Universal Fidelity [2085] $1,252 1172%
Emblem Health [2430] $1,368 1281%
Humana $1,368 1281%
Mva [1690] $1,473 1379%

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