Alys cplx sp/pn npgt w/prgrm at Ocean University Medical Center
425 Jack Martin Boulevard, Brick, NJ · Hackensack Meridian Health · · NPI 1477065126
$100.32
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.
$705.00
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.
$65.42 with KARNA vs $10,671.00 with HORIZON — 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 |
|---|---|---|---|
| KARNA | MEDICARE ADVANTAGE | $65.42 | ↓ -35% |
| WELLCARE | MEDICARE ADVANTAGE | $91.79 | ↓ -9% |
| WELLCARE | MANAGED MEDICAID | $91.79 | ↓ -9% |
| AETNA | MEDICARE ADVANTAGE | $91.79 | ↓ -9% |
| VACCN | ALL PRODUCTS | $91.79 | ↓ -9% |
| AMERIGROUP | MEDICARE ADVANTAGE | $91.79 | ↓ -9% |
| HORIZON | MEDICARE ADVANTAGE | $91.79 | ↓ -9% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $96.38 | ↓ -4% |
| AETNA | MANAGED MEDICAID | $100.11 | ↓ -0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $100.32 | ↑ +0% |
| UNITED HEALTHCARE | DSNP | $120.38 | ↑ +20% |
| CLOVER | MEDICARE ADVANTAGE | $126.90 | ↑ +26% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $136.77 | ↑ +36% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $415.25 | ↑ +314% |
| HORIZON | OMNIA | $459.24 | ↑ +358% |
| OXFORD | ALL PRODUCTS | $463.61 | ↑ +362% |
| UNITED HEALTHCARE | HMO | $485.89 | ↑ +384% |
| INTERGROUP | WORKERS COMP | $493.50 | ↑ +392% |
| INTERGROUP | SHARED SAVINGS | $493.50 | ↑ +392% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $493.50 | ↑ +392% |
| BERGEN RISK | ALL PRODUCTS | $528.75 | ↑ +427% |
| HORIZON | PIP | $544.97 | ↑ +443% |
| QUALCARE | PPO | $547.79 | ↑ +446% |
| HORIZON | SHP | $549.69 | ↑ +448% |
| AETNA | ASA | $552.02 | ↑ +450% |
| PRIME HEALTH | WORKERS COMP | $564.00 | ↑ +462% |
| PRIME HEALTH | AUTO INSURANCE | $564.00 | ↑ +462% |
| HORIZON | HMO | $567.17 | ↑ +465% |
| HORIZON | INDEMNITY | $573.87 | ↑ +472% |
| HORIZON | PPO | $582.05 | ↑ +480% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $599.25 | ↑ +497% |
| AMERIHEALTH | LOCAL HMO | $605.74 | ↑ +504% |
| QUALCARE | WORKERS COMP | $620.40 | ↑ +518% |
| CIGNA | HMO | $637.95 | ↑ +536% |
| CIGNA | PPO | $637.95 | ↑ +536% |
| AMERIHEALTH | REGIONAL HMO | $686.11 | ↑ +584% |
| HORIZON | MANAGED MEDICAID | $1,575.00 | ↑ +1470% |
| QUALCARE | HMO | $6,256.00 | ↑ +6136% |
| AETNA | HMO | $8,419.00 | ↑ +8292% |
| AETNA | PPO | $8,419.00 | ↑ +8292% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +9801% |
| HORIZON | WORKERS COMP | $10,671.00 | ↑ +10537% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Alys cplx sp/pn npgt w/prgrm at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $101.60 | $101.60 – $121.92 |
| Hackensack University Medical Center | Hackensack | $108.10 | $67.24 – $113.50 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $101.69 | $67.24 – $101.69 |
| Jersey Shore University Medical Center | Neptune City | $101.60 | $65.42 – $121.92 |
| Palisades Medical Center | North Bergen | $108.10 | $67.24 – $117.83 |
| Raritan Bay Medical Center | Perth Amboy | $101.69 | $67.24 – $364.02 |
| Riverview Medical Center | Red Bank | $101.60 | $65.42 – $121.92 |
| Southern Ocean Medical Center | Manahawkin | $100.32 | $65.42 – $120.38 |