How many shoppable procedure prices are published for Overlook Medical Center?

Overlook Medical Center in Summit, NJ currently has 119 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Overlook Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Overlook Medical Center's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

What is Overlook Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Overlook Medical Center an overall hospital quality rating of 5 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 442 Beds · urban Updated: 04/01/2026

Overlook Medical Center

99 Beauvoir Avenue, Summit, NJ 07901 · 119 Priced Procedures · 70% Patient Recommendation

CMS Overall Rating 5 / 5 Stars

Near Fair BaseRate Benchmark

1.05×vs. Fair Market Price

Typical commercial prices here are +5% above the fair benchmark (1.05×) even after accounting for local nurse/doctor wages and patient complexity.

80/100 · Corroborated

80/100Self-Pay Cash Beats Insurance 46% of the Time

File Completeness51

Price Logic95

Peer Alignment72

Clean Billing84

Real Cash Discount100

Regional Value Leader

3-Star CMS clinical quality rating paired with 1.05× fair market pricing.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Overlook Medical Center maintains elevated commercial insurance contracts (1.05× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 46% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#17 of 52 in NJ · 30th State Percentile#1,518 of 3,385 in U.S. · 44th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.99× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 46% of shoppable procedures (99/100 Cash Honesty)
5-Star CMS clinical rating with 70% patient recommendation (69/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (10.7% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Captive ER (1.7×) & laboratory (2.6×) services average 1.17× higher multiples than routine shoppable care (1.2×)
Specialty infusion drugs (J-codes) average 2.0× Medicare — verify per-unit billing on itemized statements
Unnegotiated chargemaster list prices average 15.0× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.2× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.17× Divergence

1.4× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+8% Upper Tail

Q25 0.99× · Q50 1.10× · Q75 1.19×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.2× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.2× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

1.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.6× MedicareFair

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

2.0× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

46% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 69/100Fair

Procedure Prices at Overlook Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 119 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$36,576	$60,277	$30,775	2.0×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$23,547	$45,996	$19,087	2.4×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$21,296	$42,411	$17,936	2.4×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$22,517	$30,527	$19,432	1.6×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$9,761	$18,275	$8,223	2.2×
Total knee replacement CPT Code: `27447`	$17,640	$14,971	$13,523	1.1×
Total hip replacement CPT Code: `27130`	$17,414	$14,930	$13,413	1.1×
Rabies immune globulin HCPCS Code: `90375`	$10,956	$10,956	$322	34.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$7,785	$6,770	$6,109	1.1×
Breast lump removal CPT Code: `19120`	$5,110	$4,443	$3,875	1.1×
Inguinal hernia repair CPT Code: `49505`	$4,709	$4,136	$3,629	1.1×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$4,330	$3,765	$3,372	1.1×
Bunion correction surgery CPT Code: `28296`	$4,330	$3,765	$3,446	1.1×
Cataract surgery with lens implant CPT Code: `66984`	$3,043	$2,646	$2,540	1.0×
Colonoscopy with biopsy CPT Code: `45380`	$1,573	$1,368	$1,256	1.1×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,358	$1,181	$1,021	1.2×
Upper endoscopy with biopsy CPT Code: `43239`	$1,251	$1,088	$987	1.1×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,217	$1,058	$981	1.1×
Injection procedure for pain management HCPCS Code: `G0260`	$930	$804	$855	0.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$732	$636	$583	1.1×
MRI, brain (with and without contrast) CPT Code: `70553`	$477	$602	$511	1.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$529	$530	$448	1.2×
Blood transfusion CPT Code: `36430`	$878	$507	$498	1.0×
MRI, lower back (no contrast) CPT Code: `72148`	$323	$376	$338	1.1×
MRI, brain (no contrast) CPT Code: `70551`	$323	$376	$343	1.1×
MRI, knee or other leg joint CPT Code: `73721`	$323	$376	$369	1.0×
CT scan, head (with and without contrast) CPT Code: `70470`	$238	$292	$258	1.1×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$323	$280	$272	1.0×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$323	$280	$303	0.9×
CT scan, head (with contrast) CPT Code: `70460`	$238	$292	$242	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$295	$295	$86	unverified
Psychiatric evaluation (first visit) CPT Code: `90791`	$214	$243	$185	1.3×
Ultrasound, pelvis CPT Code: `76856`	$213	$178	$130	1.4×
Ultrasound, abdomen (complete) CPT Code: `76700`	$142	$178	$134	1.3×
Breathing treatment (nebulizer) CPT Code: `94640`	—	—	$201	unverified
Psychological testing evaluation CPT Code: `96136`	$359	$174	$128	1.4×
Ultrasound, thyroid and neck CPT Code: `76536`	$142	$175	$132	1.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$218	$185	$148	1.3×
Office visit, established patient (20-29 min) CPT Code: `99213`	$78	$130	$87	1.5×
Screening mammogram (both breasts) CPT Code: `77067`	$129	$153	$123	1.2×
Ultrasound, abdomen (limited) CPT Code: `76705`	$142	$155	$126	1.2×
CT scan, head (no contrast) CPT Code: `70450`	$142	$178	$160	1.1×
CT scan, pelvis CPT Code: `72192`	$142	$178	$163	1.1×
CT scan, sinuses CPT Code: `70486`	$142	$178	$166	1.1×
CT scan, chest (no contrast) CPT Code: `71250`	$142	$178	$167	1.1×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$142	$178	$168	1.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$142	$178	$169	1.1×
X-ray, pelvis CPT Code: `72170`	—	$178	$110	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$115	$150	$123	1.2×
Psychotherapy session (60 minutes) CPT Code: `90837`	$214	$133	$181	0.7×
X-ray, chest (single view) CPT Code: `71045`	$3,951	$102	$92	1.1×
X-ray, shoulder CPT Code: `73030`	$117	$102	$92	1.1×
X-ray, foot CPT Code: `73630`	$202	$102	$92	1.1×
X-ray, hip CPT Code: `73502`	$130	$103	$93	1.1×
X-ray, lower back CPT Code: `72110`	$142	$123	$112	1.1×
X-ray, chest (two views) CPT Code: `71046`	$117	$102	$93	1.1×
X-ray, neck (cervical spine) CPT Code: `72040`	$117	$102	$93	1.1×
X-ray, hand CPT Code: `73130`	$117	$102	$93	1.1×
X-ray, ankle CPT Code: `73610`	$130	$102	$93	1.1×
Speech therapy (language evaluation) CPT Code: `92507`	$185	$83	$86	1.0×
New patient office visit (30-44 min) CPT Code: `99203`	$97	$100	$110	0.9×
Family therapy session CPT Code: `90847`	$214	$102	$173	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	$214	$90	$166	0.5×
Typhoid vaccine HCPCS Code: `90675`	$416	$388	$347	1.1×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$224	$192	$203	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$277	$141	$140	1.0×
Drug screening test HCPCS Code: `G0480`	$116	$114	$116	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$427	$105	$111	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$196	$78	$39	2.0×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$279	$83	$56	1.5×
Diagnostic procedure preparation HCPCS Code: `G0279`	$144	$57	$35	1.6×
Flu vaccine injection HCPCS Code: `G0008`	—	$54	$48	1.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$54	$49	1.1×
Colorectal cancer screening HCPCS Code: `G0010`	$79	$54	$49	1.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$405	$69	$64	1.1×
Group therapy session CPT Code: `90853`	$247	$72	$100	0.7×
Speech therapy (group session) CPT Code: `92508`	$205	$41	$27	1.5×
Hepatitis B vaccine HCPCS Code: `90744`	$33	$39	$37	1.1×
Prosthetic fitting and training CPT Code: `97761`	$122	$46	$45	1.0×
Orthotic fitting and training CPT Code: `97760`	$415	$52	$51	1.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$250	$37	$38	1.0×
Care planning with family CPT Code: `90887`	$397	$48	$107	0.4×
Blood test, sodium CPT Code: `84295`	—	$7	$5	1.4×
Blood test, hemoglobin CPT Code: `85018`	—	$4	$3	1.3×
Blood test, clotting time (PTT) CPT Code: `85730`	—	$8	$6	1.3×
Blood test, lipase CPT Code: `83690`	$183	$9	$7	1.3×
Culture, bacterial CPT Code: `87070`	—	$11	$9	1.2×
Blood test, ferritin (iron stores) CPT Code: `82728`	$47	$17	$14	1.2×
Blood test, potassium CPT Code: `84132`	—	$6	$5	1.2×
Hepatitis C antibody test CPT Code: `86803`	$87	$18	$15	1.2×
Culture, blood CPT Code: `87040`	$136	$13	$11	1.2×
Blood test, thyroid (TSH) CPT Code: `84443`	$57	$21	$18	1.2×
Flu vaccine (high dose) HCPCS Code: `90656`	$169	$27	$25	1.1×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$59	$21	$20	1.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$168	$36	$38	0.9×
Blood test, magnesium CPT Code: `83735`	$320	$7	$7	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$52	$19	$19	1.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$149	$14	$14	1.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$288	$39	$40	1.0×
Physical therapy (gait training) CPT Code: `97116`	$290	$32	$33	1.0×
Blood test, vitamin D CPT Code: `82306`	$103	$30	$31	1.0×
Physical therapy (manual therapy) CPT Code: `97140`	$166	$30	$34	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	—	—	$38	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$227	$4	$3	1.3×
Blood test, basic metabolic panel CPT Code: `80048`	$884	$11	$9	1.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$51	$11	$11	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$50	$14	$14	1.0×
Blood test, amylase CPT Code: `82150`	$119	$7	$7	1.0×
Blood test, calcium CPT Code: `82310`	$61	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$13	$5	$5	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$49	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$72	$10	$10	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$13	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$73	$8	$8	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$107	$15	$16	0.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$167	$32	$35	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$73	$5	$5	1.0×
Blood test, liver function panel CPT Code: `80076`	$321	$8	$9	0.9×
Blood antibody screen CPT Code: `86850`	$411	$12	$46	0.3×

Showing top 25 high-impact procedures of 119 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 10.7%

Audit a Bill or Quote at Overlook Medical Center (Zero PHI Required)

CMS CCN: 310051

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $36,576

Insurer Median $60,277

1. Amount on Your Bill or Quote ($) Pre-filled with Overlook Medical Center’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $14,914 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $14,914

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (10.7% of gross = $14,914).

Step 2 · Cash vs. Insurance Arbitrage Save $102,422 Paying Cash

Self-Pay Cash Rate ($36,576) Beats Your Bill

Overlook Medical Center's published 45 CFR § 180 self-pay cash rate is $36,576 (vs. $60,277 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$108,223 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($138,998) is $108,223 above the denoised Fair BaseRate ($30,775) and 5.9× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (10.7% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite69/100

Would Recommend70%

Rated 9 or 10 (HCAHPS)67%

Median ER Wait192 min

Left ER Before Seen1%

30-Day Mortality vs U.S.better

Unplanned Readmissionbetter

Hip/Knee Complication Rate3.5%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Overlook Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-04-16·administrative_or_closure
Met Requirements
Recorded
2023-05-08·administrative_or_closure
Closure Notice
Recorded
2022-01-12·cap_corrective_action
CAP Request
Recorded
2021-07-20·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (2,366 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Overlook Medical Center.

Price Index: 0.87× regional baseline

Quality: 77/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Kaiser Permanente

+84.3%

Humana

+113.9%

Oscar Health

+134.3%

Median Household Income$100,117U.S. Census ACS

Local Uninsured Share12.4%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 80/100 · Corroborated CMS CCN 310051

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 310051) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage04/01/2026

Validated Rate Rows28,192 (CMS v3.0.0)

File Integrity DigestVerified · CCN 310051

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy