CMS Price Transparency Data

X-ray, lower back

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $588
  • Cash Discount Price: $137
  • vs. Medicare Baseline: 5.51x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Hackensack Meridian Mountainside Medical is $588. 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 5.51x 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
$588

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: $588 (551%)
Cash: $137 (128% of Medicare)
Ins. Median: $588 (551% 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 551% of the Medicare baseline (a markup of 451%). 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] $73 - $588 68%
UnitedHealthcare $73 68%
Aetna $106 99%
Black Lung [6055] $284 266%
Create Flex / Select [3580] $284 266%
Healthcare Highways [2210] $284 - $588 266%
Lucent Health [6000] $284 266%
Medicare (plans) $284 266%
Oncology Patient Assistance Programs [2295] $284 266%
Selecthealth [3740] $284 266%
Web Tpa [2115] $284 266%
Worker'S Comp [2125] $284 - $643 266%
Wtc Healthcare Sme Karna [8005] $284 266%
First Health [1375] $519 - $588 486%
Cigna $554 519%
Administrative Concepts [1005] $588 551%
Allied National Global Care [1035] $588 551%
Gilsbar [1425] $588 551%
Healthcost Solutions [2415] $588 551%
Healthfirst [2395] $588 551%
Healthnet [1495] $588 551%
Hometown Health [2155] $588 551%
Mayo Clinic Health Solutions [2280] $588 551%
Multiplan [1680] $588 551%
Mutual Of Omaha [1685] $588 551%
New Era Life Insurance Company [1705] $588 551%
Pan American Life Insurance Co [1770] $588 551%
Pba [1775] $588 551%
Phcs [1780] $588 551%
Planned Administrators Inc [2360] $588 551%
Resource One Administrators [2815] $588 551%
Trustmark [2030] $588 551%
Universal Fidelity [2085] $588 551%
Emblem Health [2430] $643 602%
Humana $643 602%
Mva [1690] $692 648%

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