Nasal/sinus sphenoid endoscopy dx 31235 at Ocean University Medical Center
425 Jack Martin Boulevard, Brick, NJ · Hackensack Meridian Health · · NPI 1477065126
$1,884.64
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.
$3,934.00
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.
$329.12 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 | $329.12 | ↓ -83% |
| AETNA | MANAGED MEDICAID | $558.63 | ↓ -70% |
| CLOVER | MEDICARE ADVANTAGE | $708.12 | ↓ -62% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $763.20 | ↓ -60% |
| HORIZON | MANAGED MEDICAID | $848.00 | ↓ -55% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -37% |
| HORIZON | MEDICARE ADVANTAGE | $1,724.47 | ↓ -8% |
| AETNA | MEDICARE ADVANTAGE | $1,724.47 | ↓ -8% |
| VACCN | ALL PRODUCTS | $1,724.47 | ↓ -8% |
| AMERIGROUP | MEDICARE ADVANTAGE | $1,724.47 | ↓ -8% |
| WELLCARE | MEDICARE ADVANTAGE | $1,724.47 | ↓ -8% |
| WELLCARE | MANAGED MEDICAID | $1,724.47 | ↓ -8% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,810.69 | ↓ -4% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,884.64 | ↑ +0% |
| CIGNA | HMO | $2,248.00 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $2,261.57 | ↑ +20% |
| CIGNA | PPO | $2,519.00 | ↑ +34% |
| HORIZON | OMNIA | $2,562.61 | ↑ +36% |
| INTERGROUP | SHARED SAVINGS | $2,753.80 | ↑ +46% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $2,753.80 | ↑ +46% |
| INTERGROUP | WORKERS COMP | $2,753.80 | ↑ +46% |
| BERGEN RISK | ALL PRODUCTS | $2,950.50 | ↑ +57% |
| HORIZON | PIP | $3,040.98 | ↑ +61% |
| QUALCARE | PPO | $3,056.72 | ↑ +62% |
| HORIZON | SHP | $3,067.34 | ↑ +63% |
| AETNA | ASA | $3,080.32 | ↑ +63% |
| PRIME HEALTH | AUTO INSURANCE | $3,147.20 | ↑ +67% |
| PRIME HEALTH | WORKERS COMP | $3,147.20 | ↑ +67% |
| HORIZON | HMO | $3,164.90 | ↑ +68% |
| HORIZON | INDEMNITY | $3,202.28 | ↑ +70% |
| HORIZON | PPO | $3,247.91 | ↑ +72% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $3,343.90 | ↑ +77% |
| AMERIHEALTH | LOCAL HMO | $3,380.09 | ↑ +79% |
| QUALCARE | WORKERS COMP | $3,461.92 | ↑ +84% |
| AETNA | PPO | $3,662.00 | ↑ +94% |
| AETNA | HMO | $3,662.00 | ↑ +94% |
| AMERIHEALTH | REGIONAL HMO | $3,828.57 | ↑ +103% |
| OXFORD | ALL PRODUCTS | $6,137.00 | ↑ +226% |
| QUALCARE | HMO | $6,256.00 | ↑ +232% |
| UNITED HEALTHCARE | HMO | $7,714.00 | ↑ +309% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +427% |
| HORIZON | WORKERS COMP | $10,671.00 | ↑ +466% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Nasal/sinus sphenoid endoscopy dx 31235 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $161.69 – $3,769.28 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $283.86 – $3,869.44 |
| Community Medical Center | Toms River | $3,786.00 | $290.70 – $3,750.43 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $280.44 – $3,850.09 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $166.45 – $3,869.44 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $209.25 – $4,041.37 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $560.88 – $3,798.41 |
| Bayshore Medical Center | Holmdel | $1,908.75 | $1,908.75 – $2,290.50 |