Removal of adenoids <12yrs 42835 at Ocean University Medical Center
425 Jack Martin Boulevard, Brick, NJ · Hackensack Meridian Health · · NPI 1477065126
$3,544.29
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.
$5,948.00
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.
$421.52 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 | $421.52 | ↓ -88% |
| AETNA | MANAGED MEDICAID | $844.62 | ↓ -76% |
| CLOVER | MEDICARE ADVANTAGE | $1,070.64 | ↓ -70% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,153.91 | ↓ -67% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -66% |
| HORIZON | MANAGED MEDICAID | $1,575.00 | ↓ -56% |
| AMERIGROUP | MEDICARE ADVANTAGE | $3,243.07 | ↓ -8% |
| HORIZON | MEDICARE ADVANTAGE | $3,243.07 | ↓ -8% |
| WELLCARE | MANAGED MEDICAID | $3,243.07 | ↓ -8% |
| AETNA | MEDICARE ADVANTAGE | $3,243.07 | ↓ -8% |
| VACCN | ALL PRODUCTS | $3,243.07 | ↓ -8% |
| WELLCARE | MEDICARE ADVANTAGE | $3,243.07 | ↓ -8% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,405.22 | ↓ -4% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,544.29 | ↑ +0% |
| HORIZON | OMNIA | $3,874.53 | ↑ +9% |
| INTERGROUP | WORKERS COMP | $4,163.60 | ↑ +17% |
| INTERGROUP | SHARED SAVINGS | $4,163.60 | ↑ +17% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $4,163.60 | ↑ +17% |
| UNITED HEALTHCARE | DSNP | $4,253.14 | ↑ +20% |
| CIGNA | HMO | $4,414.00 | ↑ +25% |
| BERGEN RISK | ALL PRODUCTS | $4,461.00 | ↑ +26% |
| HORIZON | PIP | $4,597.80 | ↑ +30% |
| QUALCARE | PPO | $4,621.60 | ↑ +30% |
| HORIZON | SHP | $4,637.66 | ↑ +31% |
| AETNA | ASA | $4,657.28 | ↑ +31% |
| PRIME HEALTH | AUTO INSURANCE | $4,758.40 | ↑ +34% |
| PRIME HEALTH | WORKERS COMP | $4,758.40 | ↑ +34% |
| HORIZON | HMO | $4,785.17 | ↑ +35% |
| HORIZON | INDEMNITY | $4,841.67 | ↑ +37% |
| HORIZON | PPO | $4,910.67 | ↑ +39% |
| CIGNA | PPO | $4,945.00 | ↑ +40% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,055.80 | ↑ +43% |
| AMERIHEALTH | LOCAL HMO | $5,110.52 | ↑ +44% |
| QUALCARE | WORKERS COMP | $5,234.24 | ↑ +48% |
| AMERIHEALTH | REGIONAL HMO | $5,788.59 | ↑ +63% |
| QUALCARE | HMO | $6,256.00 | ↑ +77% |
| OXFORD | ALL PRODUCTS | $8,183.00 | ↑ +131% |
| AETNA | PPO | $8,419.00 | ↑ +138% |
| AETNA | HMO | $8,419.00 | ↑ +138% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +180% |
| UNITED HEALTHCARE | HMO | $10,334.00 | ↑ +192% |
| HORIZON | WORKERS COMP | $10,671.00 | ↑ +201% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Removal of adenoids <12yrs 42835 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $2,434.64 – $7,088.58 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $110.47 – $7,276.94 |
| Community Medical Center | Toms River | $3,786.00 | $113.14 – $7,053.14 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $109.14 – $7,240.56 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $200.32 – $7,276.94 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $119.79 – $7,600.27 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $218.28 – $7,143.34 |
| Bayshore Medical Center | Holmdel | $3,589.62 | $3,589.62 – $4,307.55 |