CMS Price Transparency Data

CT scan, pelvis

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $2,100
  • Cash Discount Price: $137
  • vs. Medicare Baseline: 19.66x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Hackensack Meridian Mountainside Medical is $2,100. 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 19.66x 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
$2,100

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: $2,100 (1966%)
Cash: $137 (128% of Medicare)
Ins. Median: $2,100 (1966% 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 1966% of the Medicare baseline (a markup of 1866%). 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] $259 - $2,100 242%
UnitedHealthcare $259 242%
Aetna $378 354%
Black Lung [6055] $1,013 948%
Create Flex / Select [3580] $1,013 948%
Healthcare Highways [2210] $1,013 - $2,100 948%
Lucent Health [6000] $1,013 948%
Medicare (plans) $1,013 948%
Oncology Patient Assistance Programs [2295] $1,013 948%
Selecthealth [3740] $1,013 948%
Web Tpa [2115] $1,013 948%
Worker'S Comp [2125] $1,013 - $2,296 948%
Wtc Healthcare Sme Karna [8005] $1,013 948%
First Health [1375] $1,853 - $2,100 1735%
Cigna $1,977 1851%
Administrative Concepts [1005] $2,100 1966%
Allied National Global Care [1035] $2,100 1966%
Gilsbar [1425] $2,100 1966%
Healthcost Solutions [2415] $2,100 1966%
Healthfirst [2395] $2,100 1966%
Healthnet [1495] $2,100 1966%
Hometown Health [2155] $2,100 1966%
Mayo Clinic Health Solutions [2280] $2,100 1966%
Multiplan [1680] $2,100 1966%
Mutual Of Omaha [1685] $2,100 1966%
New Era Life Insurance Company [1705] $2,100 1966%
Pan American Life Insurance Co [1770] $2,100 1966%
Pba [1775] $2,100 1966%
Phcs [1780] $2,100 1966%
Planned Administrators Inc [2360] $2,100 1966%
Resource One Administrators [2815] $2,100 1966%
Trustmark [2030] $2,100 1966%
Universal Fidelity [2085] $2,100 1966%
Emblem Health [2430] $2,296 2150%
Humana $2,296 2150%
Mva [1690] $2,471 2313%

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