CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $808
  • Cash Discount Price: $121
  • vs. Medicare Baseline: 6.40x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Hackensack Meridian Mountainside Medical is $808. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 6.40x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$121

Average discount available for prompt cash payment at this facility.

Insurance Median
$808

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)
Cash / Self-Pay: $121 (96%)
Insurance Median: $808 (640%)
Cash: $121 (96% of Medicare)
Ins. Median: $808 (640% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $126.25 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 640% of the Medicare baseline (a markup of 540%). 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] $100 - $808 79%
UnitedHealthcare $100 79%
Aetna $145 115%
Black Lung [6055] $390 309%
Create Flex / Select [3580] $390 309%
Healthcare Highways [2210] $390 - $808 309%
Lucent Health [6000] $390 309%
Medicare (plans) $390 309%
Oncology Patient Assistance Programs [2295] $390 309%
Selecthealth [3740] $390 309%
Web Tpa [2115] $390 309%
Worker'S Comp [2125] $390 - $883 309%
Wtc Healthcare Sme Karna [8005] $390 309%
First Health [1375] $712 - $808 564%
Cigna $760 602%
Administrative Concepts [1005] $808 640%
Allied National Global Care [1035] $808 640%
Gilsbar [1425] $808 640%
Healthcost Solutions [2415] $808 640%
Healthfirst [2395] $808 640%
Healthnet [1495] $808 640%
Hometown Health [2155] $808 640%
Mayo Clinic Health Solutions [2280] $808 640%
Multiplan [1680] $808 640%
Mutual Of Omaha [1685] $808 640%
New Era Life Insurance Company [1705] $808 640%
Pan American Life Insurance Co [1770] $808 640%
Pba [1775] $808 640%
Phcs [1780] $808 640%
Planned Administrators Inc [2360] $808 640%
Resource One Administrators [2815] $808 640%
Trustmark [2030] $808 640%
Universal Fidelity [2085] $808 640%
Emblem Health [2430] $883 699%
Humana $883 699%
Blue Cross Blue Shield $935 741%
Mva [1690] $950 752%

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