CMS Price Transparency Data

X-ray, shoulder

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $522
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 5.87x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Hackensack Meridian Mountainside Medical is $522. 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 5.87x 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
$522

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: $522 (587%)
Cash: $114 (128% of Medicare)
Ins. Median: $522 (587% 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 587% of the Medicare baseline (a markup of 487%). 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] $64 - $783 72%
UnitedHealthcare $64 - $97 72%
Aetna $94 - $141 106%
Black Lung [6055] $252 - $378 283%
Create Flex / Select [3580] $252 - $378 283%
Healthcare Highways [2210] $252 - $783 283%
Lucent Health [6000] $252 - $378 283%
Medicare (plans) $252 - $378 283%
Oncology Patient Assistance Programs [2295] $252 - $378 283%
Selecthealth [3740] $252 - $378 283%
Web Tpa [2115] $252 - $378 283%
Worker'S Comp [2125] $252 - $856 283%
Wtc Healthcare Sme Karna [8005] $252 - $378 283%
First Health [1375] $460 - $783 517%
Cigna $491 - $737 552%
Administrative Concepts [1005] $522 - $783 587%
Allied National Global Care [1035] $522 - $783 587%
Gilsbar [1425] $522 - $783 587%
Healthcost Solutions [2415] $522 - $783 587%
Healthfirst [2395] $522 - $783 587%
Healthnet [1495] $522 - $783 587%
Hometown Health [2155] $522 - $783 587%
Mayo Clinic Health Solutions [2280] $522 - $783 587%
Multiplan [1680] $522 - $783 587%
Mutual Of Omaha [1685] $522 - $783 587%
New Era Life Insurance Company [1705] $522 - $783 587%
Pan American Life Insurance Co [1770] $522 - $783 587%
Pba [1775] $522 - $783 587%
Phcs [1780] $522 - $783 587%
Planned Administrators Inc [2360] $522 - $783 587%
Resource One Administrators [2815] $522 - $783 587%
Trustmark [2030] $522 - $783 587%
Universal Fidelity [2085] $522 - $783 587%
Emblem Health [2430] $570 - $856 641%
Humana $570 - $856 641%
Mva [1690] $614 - $921 691%

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