CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $123
  • Cash Discount Price: $4
  • vs. Medicare Baseline: 38.80x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Hackensack Meridian Mountainside Medical is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 38.80x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$4

Average discount available for prompt cash payment at this facility.

Insurance Median
$123

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$3.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3.17 (100%)
Cash / Self-Pay: $4 (126%)
Insurance Median: $123 (3880%)
Cash: $4 (126% of Medicare)
Ins. Median: $123 (3880% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3.17 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 3880% of the Medicare baseline (a markup of 3780%). 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] $15 - $123 473%
UnitedHealthcare $15 473%
Aetna $22 694%
Black Lung [6055] $59 1861%
Create Flex / Select [3580] $59 1861%
Healthcare Highways [2210] $59 - $123 1861%
Lucent Health [6000] $59 1861%
Medicare (plans) $59 1861%
Oncology Patient Assistance Programs [2295] $59 1861%
Selecthealth [3740] $59 1861%
Web Tpa [2115] $59 1861%
Worker'S Comp [2125] $59 - $135 1861%
Wtc Healthcare Sme Karna [8005] $59 1861%
First Health [1375] $109 - $123 3438%
Cigna $116 3659%
Administrative Concepts [1005] $123 3880%
Allied National Global Care [1035] $123 3880%
Gilsbar [1425] $123 3880%
Healthcost Solutions [2415] $123 3880%
Healthfirst [2395] $123 3880%
Healthnet [1495] $123 3880%
Hometown Health [2155] $123 3880%
Mayo Clinic Health Solutions [2280] $123 3880%
Multiplan [1680] $123 3880%
Mutual Of Omaha [1685] $123 3880%
New Era Life Insurance Company [1705] $123 3880%
Pan American Life Insurance Co [1770] $123 3880%
Pba [1775] $123 3880%
Phcs [1780] $123 3880%
Planned Administrators Inc [2360] $123 3880%
Resource One Administrators [2815] $123 3880%
Trustmark [2030] $123 3880%
Universal Fidelity [2085] $123 3880%
Emblem Health [2430] $135 4259%
Humana $135 4259%
Blue Cross Blue Shield $143 4511%
Amerihealth [3520] $145 4574%
Mva [1690] $145 4574%

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