CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $5,060
  • Cash Discount Price: $461
  • vs. Medicare Baseline: 14.20x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Hackensack Meridian Mountainside Medical is $5,060. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $461. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 14.20x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$461

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,060

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $461 (129%)
Insurance Median: $5,060 (1420%)
Cash: $461 (129% of Medicare)
Ins. Median: $5,060 (1420% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 1420% of the Medicare baseline (a markup of 1320%). 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] $625 - $5,060 175%
UnitedHealthcare $625 175%
Aetna $911 256%
Black Lung [6055] $2,441 685%
Create Flex / Select [3580] $2,441 685%
Healthcare Highways [2210] $2,441 - $5,060 685%
Lucent Health [6000] $2,441 685%
Medicare (plans) $2,441 685%
Oncology Patient Assistance Programs [2295] $2,441 685%
Selecthealth [3740] $2,441 685%
Web Tpa [2115] $2,441 685%
Worker'S Comp [2125] $2,441 - $5,530 685%
Wtc Healthcare Sme Karna [8005] $2,441 685%
First Health [1375] $4,465 - $5,060 1253%
Cigna $4,762 1336%
Administrative Concepts [1005] $5,060 1420%
Allied National Global Care [1035] $5,060 1420%
Gilsbar [1425] $5,060 1420%
Healthcost Solutions [2415] $5,060 1420%
Healthfirst [2395] $5,060 1420%
Healthnet [1495] $5,060 1420%
Hometown Health [2155] $5,060 1420%
Mayo Clinic Health Solutions [2280] $5,060 1420%
Multiplan [1680] $5,060 1420%
Mutual Of Omaha [1685] $5,060 1420%
New Era Life Insurance Company [1705] $5,060 1420%
Pan American Life Insurance Co [1770] $5,060 1420%
Pba [1775] $5,060 1420%
Phcs [1780] $5,060 1420%
Planned Administrators Inc [2360] $5,060 1420%
Resource One Administrators [2815] $5,060 1420%
Trustmark [2030] $5,060 1420%
Universal Fidelity [2085] $5,060 1420%
Emblem Health [2430] $5,530 1551%
Humana $5,530 1551%
Mva [1690] $5,953 1670%

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