Biopsy of salivary gland 42400 at Ocean University Medical Center
425 Jack Martin Boulevard, Brick, NJ · Hackensack Meridian Health · · NPI 1477065126
$768.94
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.
$2,114.00
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.
$109.27 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 | $109.27 | ↓ -86% |
| AETNA | MANAGED MEDICAID | $235.15 | ↓ -69% |
| CLOVER | MEDICARE ADVANTAGE | $298.08 | ↓ -61% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $321.26 | ↓ -58% |
| VACCN | ALL PRODUCTS | $703.59 | ↓ -8% |
| AMERIGROUP | MEDICARE ADVANTAGE | $703.59 | ↓ -8% |
| WELLCARE | MANAGED MEDICAID | $703.59 | ↓ -8% |
| HORIZON | MEDICARE ADVANTAGE | $703.59 | ↓ -8% |
| WELLCARE | MEDICARE ADVANTAGE | $703.59 | ↓ -8% |
| AETNA | MEDICARE ADVANTAGE | $703.59 | ↓ -8% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $738.77 | ↓ -4% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $768.94 | ↑ +0% |
| UNITED HEALTHCARE | DSNP | $922.73 | ↑ +20% |
| HORIZON | OMNIA | $1,078.72 | ↑ +40% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↑ +55% |
| BERGEN RISK | ALL PRODUCTS | $1,242.00 | ↑ +62% |
| HORIZON | PIP | $1,280.09 | ↑ +66% |
| QUALCARE | PPO | $1,286.71 | ↑ +67% |
| HORIZON | SHP | $1,291.18 | ↑ +68% |
| AETNA | ASA | $1,296.65 | ↑ +69% |
| HORIZON | HMO | $1,332.25 | ↑ +73% |
| HORIZON | INDEMNITY | $1,347.98 | ↑ +75% |
| HORIZON | PPO | $1,367.19 | ↑ +78% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $1,407.60 | ↑ +83% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $1,407.60 | ↑ +83% |
| AMERIHEALTH | LOCAL HMO | $1,422.84 | ↑ +85% |
| QUALCARE | WORKERS COMP | $1,457.28 | ↑ +90% |
| INTERGROUP | SHARED SAVINGS | $1,479.80 | ↑ +92% |
| INTERGROUP | WORKERS COMP | $1,479.80 | ↑ +92% |
| HORIZON | MANAGED MEDICAID | $1,575.00 | ↑ +105% |
| AMERIHEALTH | REGIONAL HMO | $1,611.62 | ↑ +110% |
| PRIME HEALTH | WORKERS COMP | $1,691.20 | ↑ +120% |
| PRIME HEALTH | AUTO INSURANCE | $1,691.20 | ↑ +120% |
| CIGNA | PPO | $1,912.96 | ↑ +149% |
| CIGNA | HMO | $1,912.96 | ↑ +149% |
| AETNA | HMO | $4,025.00 | ↑ +423% |
| AETNA | PPO | $4,025.00 | ↑ +423% |
| OXFORD | ALL PRODUCTS | $4,090.00 | ↑ +432% |
| UNITED HEALTHCARE | HMO | $5,092.00 | ↑ +562% |
| QUALCARE | HMO | $6,256.00 | ↑ +714% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +1192% |
| HORIZON | WORKERS COMP | $10,671.00 | ↑ +1288% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $778.78 | $778.78 – $934.53 |
| Hackensack University Medical Center | Hackensack | $828.59 | $113.25 – $870.02 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $779.45 | $58.80 – $779.45 |
| Jersey Shore University Medical Center | Neptune City | $778.78 | $109.27 – $934.53 |
| Palisades Medical Center | North Bergen | $828.59 | $113.25 – $903.16 |
| Raritan Bay Medical Center | Perth Amboy | $779.45 | $113.25 – $935.34 |
| Riverview Medical Center | Red Bank | $778.78 | $109.27 – $934.53 |
| Southern Ocean Medical Center | Manahawkin | $768.94 | $109.27 – $922.73 |