CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $655
  • Cash Discount Price: $137
  • vs. Medicare Baseline: 6.13x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Hackensack Meridian Mountainside Medical is $655. 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 6.13x 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
$655

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: $655 (613%)
Cash: $137 (128% of Medicare)
Ins. Median: $655 (613% 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 613% of the Medicare baseline (a markup of 513%). 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] $81 - $654 76%
UnitedHealthcare $81 76%
Aetna $118 110%
Black Lung [6055] $316 296%
Create Flex / Select [3580] $316 296%
Healthcare Highways [2210] $316 - $654 296%
Lucent Health [6000] $316 296%
Medicare (plans) $316 296%
Oncology Patient Assistance Programs [2295] $316 296%
Selecthealth [3740] $316 296%
Web Tpa [2115] $316 296%
Worker'S Comp [2125] $316 - $715 296%
Wtc Healthcare Sme Karna [8005] $316 296%
First Health [1375] $578 - $654 541%
Cigna $616 577%
Administrative Concepts [1005] $654 612%
Allied National Global Care [1035] $654 612%
Gilsbar [1425] $654 612%
Healthcost Solutions [2415] $654 612%
Healthfirst [2395] $654 612%
Healthnet [1495] $654 612%
Hometown Health [2155] $654 612%
Mayo Clinic Health Solutions [2280] $654 612%
Multiplan [1680] $654 612%
Mutual Of Omaha [1685] $654 612%
New Era Life Insurance Company [1705] $654 612%
Pan American Life Insurance Co [1770] $654 612%
Pba [1775] $654 612%
Phcs [1780] $654 612%
Planned Administrators Inc [2360] $654 612%
Resource One Administrators [2815] $654 612%
Trustmark [2030] $654 612%
Universal Fidelity [2085] $654 612%
Emblem Health [2430] $715 669%
Humana $715 669%
Mva [1690] $770 721%

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