CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $482
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 5.42x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Hackensack Meridian Mountainside Medical is $482. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.42x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$482

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $114 (128%)
Insurance Median: $482 (542%)
Cash: $114 (128% of Medicare)
Ins. Median: $482 (542% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 542% of the Medicare baseline (a markup of 442%). 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] $60 - $482 67%
UnitedHealthcare $60 67%
Aetna $87 98%
Black Lung [6055] $232 261%
Create Flex / Select [3580] $232 261%
Healthcare Highways [2210] $232 - $482 261%
Lucent Health [6000] $232 261%
Medicare (plans) $232 261%
Oncology Patient Assistance Programs [2295] $232 261%
Selecthealth [3740] $232 261%
Web Tpa [2115] $232 261%
Worker'S Comp [2125] $232 - $527 261%
Wtc Healthcare Sme Karna [8005] $232 261%
First Health [1375] $425 - $482 478%
Cigna $454 511%
Administrative Concepts [1005] $482 542%
Allied National Global Care [1035] $482 542%
Gilsbar [1425] $482 542%
Healthcost Solutions [2415] $482 542%
Healthfirst [2395] $482 542%
Healthnet [1495] $482 542%
Hometown Health [2155] $482 542%
Mayo Clinic Health Solutions [2280] $482 542%
Multiplan [1680] $482 542%
Mutual Of Omaha [1685] $482 542%
New Era Life Insurance Company [1705] $482 542%
Pan American Life Insurance Co [1770] $482 542%
Pba [1775] $482 542%
Phcs [1780] $482 542%
Planned Administrators Inc [2360] $482 542%
Resource One Administrators [2815] $482 542%
Trustmark [2030] $482 542%
Universal Fidelity [2085] $482 542%
Emblem Health [2430] $527 593%
Humana $527 593%
Mva [1690] $567 638%

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