CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $3,416
  • Cash Discount Price: $504
  • vs. Medicare Baseline: 14.01x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Hackensack Meridian Mountainside Medical is $3,416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $504. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.01x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$504

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,416

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $504 (207%)
Insurance Median: $3,416 (1401%)
Cash: $504 (207% of Medicare)
Ins. Median: $3,416 (1401% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 1401% of the Medicare baseline (a markup of 1301%). 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] $422 - $5,124 173%
UnitedHealthcare $422 - $633 173%
Aetna $615 - $922 252%
Black Lung [6055] $1,648 - $2,472 676%
Create Flex / Select [3580] $1,648 - $2,472 676%
Healthcare Highways [2210] $1,648 - $5,124 676%
Lucent Health [6000] $1,648 - $2,472 676%
Medicare (plans) $1,648 - $2,472 676%
Oncology Patient Assistance Programs [2295] $1,648 - $2,472 676%
Selecthealth [3740] $1,648 - $2,472 676%
Web Tpa [2115] $1,648 - $2,472 676%
Worker'S Comp [2125] $1,648 - $5,600 676%
Wtc Healthcare Sme Karna [8005] $1,648 - $2,472 676%
First Health [1375] $3,014 - $5,124 1236%
Cigna $3,215 - $4,823 1319%
Administrative Concepts [1005] $3,416 - $5,124 1401%
Allied National Global Care [1035] $3,416 - $5,124 1401%
Gilsbar [1425] $3,416 - $5,124 1401%
Healthcost Solutions [2415] $3,416 - $5,124 1401%
Healthfirst [2395] $3,416 - $5,124 1401%
Healthnet [1495] $3,416 - $5,124 1401%
Hometown Health [2155] $3,416 - $5,124 1401%
Mayo Clinic Health Solutions [2280] $3,416 - $5,124 1401%
Multiplan [1680] $3,416 - $5,124 1401%
Mutual Of Omaha [1685] $3,416 - $5,124 1401%
New Era Life Insurance Company [1705] $3,416 - $5,124 1401%
Pan American Life Insurance Co [1770] $3,416 - $5,124 1401%
Pba [1775] $3,416 - $5,124 1401%
Phcs [1780] $3,416 - $5,124 1401%
Planned Administrators Inc [2360] $3,416 - $5,124 1401%
Resource One Administrators [2815] $3,416 - $5,124 1401%
Trustmark [2030] $3,416 - $5,124 1401%
Universal Fidelity [2085] $3,416 - $5,124 1401%
Emblem Health [2430] $3,734 - $5,600 1532%
Humana $3,734 - $5,600 1532%
Mva [1690] $4,019 - $6,028 1649%

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