Arthro/shoul surg; w/spacer at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$14,254.12
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.
$21,209.00
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.
$1,967.00 with HORIZON vs $25,800.00 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 |
|---|---|---|---|
| HORIZON | MANAGED MEDICAID | $1,967.00 | ↓ -86% |
| AETNA | MANAGED MEDICAID | $3,414.65 | ↓ -76% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $3,645.83 | ↓ -74% |
| CLOVER | MEDICARE ADVANTAGE | $3,817.62 | ↓ -73% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $4,559.94 | ↓ -68% |
| HORIZON | OMNIA | $7,564.00 | ↓ -47% |
| HORIZON | WORKERS COMP | $8,173.00 | ↓ -43% |
| HORIZON | PIP | $8,615.00 | ↓ -40% |
| HORIZON | SHP | $8,665.00 | ↓ -39% |
| QUALCARE | WORKERS COMP | $9,170.00 | ↓ -36% |
| CIGNA | HMO | $9,178.00 | ↓ -36% |
| QUALCARE | PPO | $9,342.00 | ↓ -34% |
| QUALCARE | HMO | $9,342.00 | ↓ -34% |
| HORIZON | HMO | $9,360.00 | ↓ -34% |
| HORIZON | INDEMNITY | $9,469.00 | ↓ -34% |
| HORIZON | PPO | $9,581.00 | ↓ -33% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↓ -29% |
| AETNA | PPO | $10,692.00 | ↓ -25% |
| AETNA | ASA | $10,692.00 | ↓ -25% |
| AETNA | HMO | $10,692.00 | ↓ -25% |
| AMERIHEALTH | LOCAL HMO | $10,711.00 | ↓ -25% |
| CIGNA | PPO | $10,771.00 | ↓ -24% |
| AMERIHEALTH | REGIONAL HMO | $11,904.00 | ↓ -16% |
| WELLCARE | MANAGED MEDICAID | $12,866.82 | ↓ -10% |
| VACCN | ALL PRODUCTS | $12,866.82 | ↓ -10% |
| WELLCARE | MEDICARE ADVANTAGE | $12,866.82 | ↓ -10% |
| AMERIGROUP | MEDICARE ADVANTAGE | $12,866.82 | ↓ -10% |
| HORIZON | MEDICARE ADVANTAGE | $12,866.82 | ↓ -10% |
| AETNA | MEDICARE ADVANTAGE | $12,866.82 | ↓ -10% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $13,510.16 | ↓ -5% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $14,254.12 | ↑ +0% |
| INTERGROUP | WORKERS COMP | $14,846.30 | ↑ +4% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $14,846.30 | ↑ +4% |
| INTERGROUP | SHARED SAVINGS | $14,846.30 | ↑ +4% |
| BERGEN RISK | ALL PRODUCTS | $15,603.00 | ↑ +9% |
| PRIME HEALTH | AUTO INSURANCE | $16,967.20 | ↑ +19% |
| PRIME HEALTH | WORKERS COMP | $16,967.20 | ↑ +19% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $18,027.65 | ↑ +26% |
| OXFORD | ALL PRODUCTS | $20,656.00 | ↑ +45% |
| UNITED HEALTHCARE | HMO | $25,800.00 | ↑ +81% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Arthro/shoul surg; w/spacer at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $14,241.77 | $14,241.77 – $17,090.12 |
| Hackensack University Medical Center | Hackensack | $15,152.74 | $12,122.19 – $15,910.38 |
| Ocean University Medical Center | Brick | $14,061.89 | $12,866.82 – $16,874.27 |
| Jersey Shore University Medical Center | Neptune City | $14,241.77 | $14,241.77 – $17,090.12 |
| Palisades Medical Center | North Bergen | $15,152.74 | $15,152.74 – $16,516.49 |
| Raritan Bay Medical Center | Perth Amboy | $14,254.12 | $14,254.12 – $17,104.94 |
| Riverview Medical Center | Red Bank | $14,241.77 | $14,241.77 – $17,090.12 |
| Southern Ocean Medical Center | Manahawkin | $14,061.89 | $14,061.89 – $16,874.27 |