healthcosts.net
Tonsillectomy (age 12+) 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.
$7,186.00
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.
$539.41 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 | $539.41 | ↓ -85% |
| AETNA | MANAGED MEDICAID | $792.36 | ↓ -78% |
| CLOVER | MEDICARE ADVANTAGE | $1,004.40 | ↓ -72% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,082.52 | ↓ -69% |
| 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% |
| AETNA | MEDICARE ADVANTAGE | $3,243.07 | ↓ -8% |
| WELLCARE | MEDICARE ADVANTAGE | $3,243.07 | ↓ -8% |
| VACCN | ALL PRODUCTS | $3,243.07 | ↓ -8% |
| WELLCARE | MANAGED MEDICAID | $3,243.07 | ↓ -8% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,405.22 | ↓ -4% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,544.29 | ↑ +0% |
| HORIZON | OMNIA | $3,634.81 | ↑ +3% |
| BERGEN RISK | ALL PRODUCTS | $4,185.00 | ↑ +18% |
| UNITED HEALTHCARE | DSNP | $4,253.14 | ↑ +20% |
| HORIZON | PIP | $4,313.34 | ↑ +22% |
| QUALCARE | PPO | $4,335.66 | ↑ +22% |
| HORIZON | SHP | $4,350.73 | ↑ +23% |
| AETNA | ASA | $4,369.14 | ↑ +23% |
| CIGNA | HMO | $4,414.00 | ↑ +25% |
| HORIZON | HMO | $4,489.11 | ↑ +27% |
| HORIZON | INDEMNITY | $4,542.12 | ↑ +28% |
| HORIZON | PPO | $4,606.85 | ↑ +30% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,743.00 | ↑ +34% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $4,743.00 | ↑ +34% |
| AMERIHEALTH | LOCAL HMO | $4,794.34 | ↑ +35% |
| QUALCARE | WORKERS COMP | $4,910.40 | ↑ +39% |
| CIGNA | PPO | $4,945.00 | ↑ +40% |
| INTERGROUP | SHARED SAVINGS | $5,030.20 | ↑ +42% |
| INTERGROUP | WORKERS COMP | $5,030.20 | ↑ +42% |
| AMERIHEALTH | REGIONAL HMO | $5,430.46 | ↑ +53% |
| PRIME HEALTH | WORKERS COMP | $5,748.80 | ↑ +62% |
| PRIME HEALTH | AUTO INSURANCE | $5,748.80 | ↑ +62% |
| 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
Tonsillectomy (age 12+) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $3,589.62 | $915.12 – $4,794.34 |
| Hackensack University Medical Center | Hackensack | $3,819.23 | $559.42 – $6,467.40 |