CMS Price Transparency Data

X-ray, pelvis

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $444
  • Cash Discount Price: $137
  • vs. Medicare Baseline: 4.16x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Hackensack Meridian Mountainside Medical is $444. 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 4.16x 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
$444

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: $444 (416%)
Cash: $137 (128% of Medicare)
Ins. Median: $444 (416% 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 416% of the Medicare baseline (a markup of 316%). 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] $55 - $444 51%
UnitedHealthcare $55 51%
Aetna $80 75%
Black Lung [6055] $214 200%
Create Flex / Select [3580] $214 200%
Healthcare Highways [2210] $214 - $444 200%
Lucent Health [6000] $214 200%
Medicare (plans) $214 200%
Oncology Patient Assistance Programs [2295] $214 200%
Selecthealth [3740] $214 200%
Web Tpa [2115] $214 200%
Worker'S Comp [2125] $214 - $485 200%
Wtc Healthcare Sme Karna [8005] $214 200%
First Health [1375] $391 - $444 366%
Cigna $417 390%
Administrative Concepts [1005] $444 416%
Allied National Global Care [1035] $444 416%
Gilsbar [1425] $444 416%
Healthcost Solutions [2415] $444 416%
Healthfirst [2395] $444 416%
Healthnet [1495] $444 416%
Hometown Health [2155] $444 416%
Mayo Clinic Health Solutions [2280] $444 416%
Multiplan [1680] $444 416%
Mutual Of Omaha [1685] $444 416%
New Era Life Insurance Company [1705] $444 416%
Pan American Life Insurance Co [1770] $444 416%
Pba [1775] $444 416%
Phcs [1780] $444 416%
Planned Administrators Inc [2360] $444 416%
Resource One Administrators [2815] $444 416%
Trustmark [2030] $444 416%
Universal Fidelity [2085] $444 416%
Emblem Health [2430] $485 454%
Humana $485 454%
Mva [1690] $522 489%

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