healthcosts.net
Colonoscopy (with biopsy) at Ocean University Medical Center
425 Jack Martin Boulevard, Brick, NJ · Hackensack Meridian Health · · NPI 1477065126
$1,288.59
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.
$4,294.00
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.
$406.45 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 | $406.45 | ↓ -68% |
| AETNA | MANAGED MEDICAID | $609.75 | ↓ -53% |
| CLOVER | MEDICARE ADVANTAGE | $772.92 | ↓ -40% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $833.04 | ↓ -35% |
| HORIZON | MANAGED MEDICAID | $1,115.00 | ↓ -13% |
| AMERIGROUP | MEDICARE ADVANTAGE | $1,179.08 | ↓ -8% |
| HORIZON | MEDICARE ADVANTAGE | $1,179.08 | ↓ -8% |
| AETNA | MEDICARE ADVANTAGE | $1,179.08 | ↓ -8% |
| WELLCARE | MEDICARE ADVANTAGE | $1,179.08 | ↓ -8% |
| VACCN | ALL PRODUCTS | $1,179.08 | ↓ -8% |
| WELLCARE | MANAGED MEDICAID | $1,179.08 | ↓ -8% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -8% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,238.03 | ↓ -4% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,288.59 | ↑ +0% |
| UNITED HEALTHCARE | DSNP | $1,546.31 | ↑ +20% |
| HORIZON | OMNIA | $2,797.11 | ↑ +117% |
| INTERGROUP | SHARED SAVINGS | $3,005.80 | ↑ +133% |
| INTERGROUP | WORKERS COMP | $3,005.80 | ↑ +133% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $3,005.80 | ↑ +133% |
| CIGNA | HMO | $3,137.00 | ↑ +143% |
| BERGEN RISK | ALL PRODUCTS | $3,220.50 | ↑ +150% |
| HORIZON | PIP | $3,319.26 | ↑ +158% |
| QUALCARE | PPO | $3,336.44 | ↑ +159% |
| HORIZON | SHP | $3,348.03 | ↑ +160% |
| AETNA | ASA | $3,362.20 | ↑ +161% |
| PRIME HEALTH | WORKERS COMP | $3,435.20 | ↑ +167% |
| PRIME HEALTH | AUTO INSURANCE | $3,435.20 | ↑ +167% |
| HORIZON | HMO | $3,454.52 | ↑ +168% |
| HORIZON | INDEMNITY | $3,495.32 | ↑ +171% |
| CIGNA | PPO | $3,511.00 | ↑ +172% |
| HORIZON | PPO | $3,545.13 | ↑ +175% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $3,649.90 | ↑ +183% |
| AMERIHEALTH | LOCAL HMO | $3,689.40 | ↑ +186% |
| QUALCARE | WORKERS COMP | $3,778.72 | ↑ +193% |
| AMERIHEALTH | REGIONAL HMO | $4,178.92 | ↑ +224% |
| OXFORD | ALL PRODUCTS | $6,137.00 | ↑ +376% |
| QUALCARE | HMO | $6,256.00 | ↑ +385% |
| UNITED HEALTHCARE | HMO | $7,714.00 | ↑ +499% |
| AETNA | PPO | $8,419.00 | ↑ +553% |
| AETNA | HMO | $8,419.00 | ↑ +553% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +671% |
| HORIZON | WORKERS COMP | $10,671.00 | ↑ +728% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Colonoscopy (with biopsy) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $1,305.08 | $704.22 – $3,689.40 |
| Hackensack University Medical Center | Hackensack | $1,388.56 | $418.63 – $3,864.60 |