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Tonsillectomy (child under 12) at Ocean University Medical Center
425 Jack Martin Boulevard, Brick, NJ · Hackensack Meridian Health · · NPI 1477065126
$6,465.11
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.
$10,303.00
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.
$566.98 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 | $566.98 | ↓ -91% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -82% |
| AETNA | MANAGED MEDICAID | $1,415.17 | ↓ -78% |
| HORIZON | MANAGED MEDICAID | $1,575.00 | ↓ -76% |
| CLOVER | MEDICARE ADVANTAGE | $1,793.88 | ↓ -72% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,933.40 | ↓ -70% |
| CIGNA | HMO | $4,414.00 | ↓ -32% |
| CIGNA | PPO | $4,945.00 | ↓ -24% |
| AMERIGROUP | MEDICARE ADVANTAGE | $5,915.66 | ↓ -8% |
| HORIZON | MEDICARE ADVANTAGE | $5,915.66 | ↓ -8% |
| AETNA | MEDICARE ADVANTAGE | $5,915.66 | ↓ -8% |
| WELLCARE | MEDICARE ADVANTAGE | $5,915.66 | ↓ -8% |
| VACCN | ALL PRODUCTS | $5,915.66 | ↓ -8% |
| WELLCARE | MANAGED MEDICAID | $5,915.66 | ↓ -8% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $6,211.44 | ↓ -4% |
| QUALCARE | HMO | $6,256.00 | ↓ -3% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $6,465.11 | ↑ +0% |
| HORIZON | OMNIA | $6,491.85 | ↑ +0% |
| INTERGROUP | SHARED SAVINGS | $7,212.10 | ↑ +12% |
| INTERGROUP | WORKERS COMP | $7,212.10 | ↑ +12% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $7,212.10 | ↑ +12% |
| BERGEN RISK | ALL PRODUCTS | $7,474.50 | ↑ +16% |
| HORIZON | PIP | $7,703.72 | ↑ +19% |
| QUALCARE | PPO | $7,743.58 | ↑ +20% |
| UNITED HEALTHCARE | DSNP | $7,758.13 | ↑ +20% |
| HORIZON | SHP | $7,770.49 | ↑ +20% |
| AETNA | ASA | $7,803.38 | ↑ +21% |
| HORIZON | HMO | $8,017.65 | ↑ +24% |
| HORIZON | INDEMNITY | $8,112.32 | ↑ +25% |
| OXFORD | ALL PRODUCTS | $8,183.00 | ↑ +27% |
| HORIZON | PPO | $8,227.93 | ↑ +27% |
| PRIME HEALTH | WORKERS COMP | $8,242.40 | ↑ +27% |
| PRIME HEALTH | AUTO INSURANCE | $8,242.40 | ↑ +27% |
| AETNA | PPO | $8,419.00 | ↑ +30% |
| AETNA | HMO | $8,419.00 | ↑ +30% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $8,471.10 | ↑ +31% |
| AMERIHEALTH | LOCAL HMO | $8,562.79 | ↑ +32% |
| QUALCARE | WORKERS COMP | $8,770.08 | ↑ +36% |
| AMERIHEALTH | REGIONAL HMO | $9,698.91 | ↑ +50% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +54% |
| UNITED HEALTHCARE | HMO | $10,334.00 | ↑ +60% |
| HORIZON | WORKERS COMP | $10,671.00 | ↑ +65% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Tonsillectomy (child under 12) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $6,547.81 | $1,634.42 – $8,562.79 |
| Hackensack University Medical Center | Hackensack | $6,966.64 | $588.47 – $9,272.70 |