CMS Price Transparency Data

Colorectal cancer screening

Facility: Hackensack Meridian Mountainside Medical

Billing Code: G0010 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0010
  • Insurance Median: $124
  • Cash Discount Price: $60
  • vs. Medicare Baseline: 2.59x Medicare
The contracted insurance negotiated median rate for a Colorectal cancer screening at Hackensack Meridian Mountainside Medical is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $47.84, this hospital’s rate is 2.59x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$60

Average discount available for prompt cash payment at this facility.

Insurance Median
$124

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$47.84

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $47.84 (100%)
Cash / Self-Pay: $60 (125%)
Insurance Median: $124 (259%)
Cash: $60 (125% of Medicare)
Ins. Median: $124 (259% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $47.84 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 259% of the Medicare baseline (a markup of 159%). 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] $15 - $124 31%
UnitedHealthcare $15 31%
Aetna $22 - $128 46%
Lucent Health [6000] $60 125%
Web Tpa [2115] $60 - $128 125%
Oncology Patient Assistance Programs [2295] $60 125%
Healthcare Highways [2210] $60 - $124 125%
Selecthealth [3740] $60 125%
Wtc Healthcare Sme Karna [8005] $60 125%
Medicare (plans) $60 125%
Worker's Comp [2125] $60 125%
Black Lung [6055] $60 125%
Create Flex / Select [3580] $60 125%
First Health [1375] $110 - $124 230%
Administrative Concepts [1005] $124 259%
Planned Administrators Inc [2360] $124 259%
Hometown Health [2155] $124 259%
Multiplan [1680] $124 259%
Pba [1775] $124 259%
Mutual of Omaha [1685] $124 259%
Healthcost Solutions [2415] $124 259%
Trustmark [2030] $124 259%
Pan American Life Insurance Co [1770] $124 259%
Mayo Clinic Health Solutions [2280] $124 259%
Universal Fidelity [2085] $124 259%
Gilsbar [1425] $124 259%
PHCS [1780] $124 259%
Allied National Global Care [1035] $124 259%
Healthfirst [2395] $124 259%
Healthnet [1495] $124 259%
Resource One Administrators [2815] $124 259%
New Era Life Insurance Company [1705] $124 259%
Meritain Health [1655] $128 268%
1199 Seiu Benefit Fund [3505] $128 268%
Allied Benefit Systems Inc [1030] $128 268%
Samba Health [2305] $142 297%
Cigna $142 297%
National Association of Letter Carriers [1695] $142 297%
Mvp Health Plan [2180] $142 297%
Amerihealth [3520] $146 305%
Mva [1690] $146 305%

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