Nasal/sinus endo w/front sinus expl 31276 at Ocean University Medical Center
425 Jack Martin Boulevard, Brick, NJ · Hackensack Meridian Health · · NPI 1477065126
$7,565.43
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.
$12,547.00
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.
$773.52 with KARNA vs $14,134.00 with UNITED HEALTHCARE — 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 | $773.52 | ↓ -90% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -84% |
| HORIZON | MANAGED MEDICAID | $1,277.00 | ↓ -83% |
| AETNA | MANAGED MEDICAID | $1,746.03 | ↓ -77% |
| CLOVER | MEDICARE ADVANTAGE | $2,213.28 | ↓ -71% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $2,385.42 | ↓ -68% |
| AETNA | MEDICARE ADVANTAGE | $2,508.38 | ↓ -67% |
| CIGNA | HMO | $3,588.00 | ↓ -53% |
| CIGNA | PPO | $4,015.00 | ↓ -47% |
| QUALCARE | HMO | $6,256.00 | ↓ -17% |
| HORIZON | MEDICARE ADVANTAGE | $6,922.47 | ↓ -8% |
| WELLCARE | MEDICARE ADVANTAGE | $6,922.47 | ↓ -8% |
| WELLCARE | MANAGED MEDICAID | $6,922.47 | ↓ -8% |
| AMERIGROUP | MEDICARE ADVANTAGE | $6,922.47 | ↓ -8% |
| VACCN | ALL PRODUCTS | $6,922.47 | ↓ -8% |
| HORIZON | OMNIA | $7,014.00 | ↓ -7% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $7,268.59 | ↓ -4% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $7,565.43 | ↑ +0% |
| HORIZON | SHP | $8,000.00 | ↑ +6% |
| AETNA | PPO | $8,419.00 | ↑ +11% |
| AETNA | HMO | $8,419.00 | ↑ +11% |
| HORIZON | HMO | $8,659.00 | ↑ +14% |
| HORIZON | INDEMNITY | $8,750.00 | ↑ +16% |
| INTERGROUP | WORKERS COMP | $8,782.90 | ↑ +16% |
| INTERGROUP | SHARED SAVINGS | $8,782.90 | ↑ +16% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $8,782.90 | ↑ +16% |
| HORIZON | PPO | $8,885.00 | ↑ +17% |
| UNITED HEALTHCARE | DSNP | $9,078.51 | ↑ +20% |
| BERGEN RISK | ALL PRODUCTS | $9,222.00 | ↑ +22% |
| HORIZON | PIP | $9,504.81 | ↑ +26% |
| QUALCARE | PPO | $9,553.99 | ↑ +26% |
| AETNA | ASA | $9,627.77 | ↑ +27% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +31% |
| PRIME HEALTH | WORKERS COMP | $10,037.60 | ↑ +33% |
| PRIME HEALTH | AUTO INSURANCE | $10,037.60 | ↑ +33% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $10,451.60 | ↑ +38% |
| AMERIHEALTH | LOCAL HMO | $10,564.72 | ↑ +40% |
| BRIGHTON HEALTH PLAN | PNO | $10,655.47 | ↑ +41% |
| HORIZON | WORKERS COMP | $10,671.00 | ↑ +41% |
| QUALCARE | WORKERS COMP | $10,820.48 | ↑ +43% |
| OXFORD | ALL PRODUCTS | $11,153.00 | ↑ +47% |
| AMERIHEALTH | REGIONAL HMO | $11,966.47 | ↑ +58% |
| UNITED HEALTHCARE | HMO | $14,134.00 | ↑ +87% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Nasal/sinus endo w/front sinus expl 31276 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $190.31 – $15,130.86 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $705.50 – $15,532.92 |
| Community Medical Center | Toms River | $3,786.00 | $722.50 – $15,055.21 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $697.00 – $15,455.26 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $195.91 – $15,532.92 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $246.29 – $16,223.12 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $1,394.00 – $15,247.80 |
| Bayshore Medical Center | Holmdel | $7,662.21 | $7,662.21 – $9,194.65 |