Biopsy of heart lining at Clara Maass Medical Center
1 Clara Maass Dr, Belleville, NJ · RWJBarnabas Health · · NPI 1902901333
$811.11
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$4,078.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$519.53 with United Healthcare vs $14,722.00 with Aetna — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| United Healthcare | Community Plan | $519.53 | ↓ -36% |
| Fidelis Care | NJ Family Care | $529.32 | ↓ -35% |
| Aetna | Better Health | $568.88 | ↓ -30% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $1,715.61 | ↑ +112% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $2,131.16 | ↑ +163% |
| Cigna | Local Plus | $2,146.25 | ↑ +165% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $2,183.76 | ↑ +169% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $2,251.87 | ↑ +178% |
| First Health | Commercial | $2,446.80 | ↑ +202% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $2,674.84 | ↑ +230% |
| Cigna | HMO | $2,727.36 | ↑ +236% |
| Cigna | PPO | $2,872.54 | ↑ +254% |
| Qualcare Inc | HMO/POS | $3,131.90 | ↑ +286% |
| Wellpoint | NJ Family Care | $3,180.00 | ↑ +292% |
| Qualcare Inc | PPO/WC | $3,339.88 | ↑ +312% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $3,531.24 | ↑ +335% |
| Humana | Medicare | $3,531.24 | ↑ +335% |
| Aetna | Medicare | $3,531.24 | ↑ +335% |
| Wellpoint | Medicare Advantage | $3,531.24 | ↑ +335% |
| Clover Health | Medicare Advantage | $3,531.24 | ↑ +335% |
| Fidelis Care | Medicare Advantage | $3,531.24 | ↑ +335% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $3,579.26 | ↑ +341% |
| United Healthcare | Medicare | $3,601.86 | ↑ +344% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $3,892.85 | ↑ +380% |
| United Healthcare | Oxford Metro | $4,332.00 | ↑ +434% |
| United Healthcare | Nexus | $5,085.00 | ↑ +527% |
| United Healthcare | Oxford Commercial | $5,097.00 | ↑ +528% |
| United Healthcare | Commercial | $5,982.00 | ↑ +638% |
| Emblem Health | Commercial | $6,179.67 | ↑ +662% |
| Wellcare | Ambetter Health Commercial | $7,027.17 | ↑ +766% |
| Aetna | PPO | $14,722.00 | ↑ +1715% |
| Aetna | HMO | $14,722.00 | ↑ +1715% |
| Amerihealth | Local Value | not published by hospital | — |
| Amerihealth | Regional Preferred | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of heart lining at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $1,252.33 | $330.84 – $6,879.68 |
| Cooperman Barnabas Medical Center | Livingston | $2,618.02 | $2,707.46 – $7,062.48 |
| Newark Beth Israel Medical Center | Newark | $2,573.54 | $340.57 – $7,062.48 |
| Jersey City Medical Center | Jersey City | $1,386.44 | $428.14 – $7,376.29 |
| Bayshore Medical Center | Holmdel | $3,483.84 | $3,483.84 – $4,180.61 |
| Hackensack University Medical Center | Hackensack | $3,706.68 | $1,132.92 – $3,892.02 |
| Ocean University Medical Center | Brick | $3,439.84 | $1,081.12 – $14,806.00 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $3,486.86 | $1,132.92 – $14,806.00 |