Biopsy of lip 40490 at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$257.26
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.
$826.00
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.
$36.40 with HORIZON vs $10,163.00 with BRIGHTON HEALTH PLAN — 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 | $36.40 | ↓ -86% |
| AETNA | MANAGED MEDICAID | $132.99 | ↓ -48% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $141.99 | ↓ -45% |
| KARNA | MEDICARE ADVANTAGE | $146.01 | ↓ -43% |
| CLOVER | MEDICARE ADVANTAGE | $148.68 | ↓ -42% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $177.59 | ↓ -31% |
| VACCN | ALL PRODUCTS | $232.22 | ↓ -10% |
| AMERIGROUP | MEDICARE ADVANTAGE | $232.22 | ↓ -10% |
| HORIZON | MEDICARE ADVANTAGE | $232.22 | ↓ -10% |
| AETNA | MEDICARE ADVANTAGE | $232.22 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $232.22 | ↓ -10% |
| WELLCARE | MEDICARE ADVANTAGE | $232.22 | ↓ -10% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $243.83 | ↓ -5% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $257.26 | ↑ +0% |
| INTERGROUP | WORKERS COMP | $578.20 | ↑ +125% |
| INTERGROUP | SHARED SAVINGS | $578.20 | ↑ +125% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $578.20 | ↑ +125% |
| HORIZON | OMNIA | $607.77 | ↑ +136% |
| BERGEN RISK | ALL PRODUCTS | $619.50 | ↑ +141% |
| PRIME HEALTH | WORKERS COMP | $660.80 | ↑ +157% |
| PRIME HEALTH | AUTO INSURANCE | $660.80 | ↑ +157% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $702.10 | ↑ +173% |
| HORIZON | SHP | $724.57 | ↑ +182% |
| CIGNA | HMO | $747.45 | ↑ +191% |
| CIGNA | PPO | $747.45 | ↑ +191% |
| HORIZON | HMO | $749.93 | ↑ +192% |
| HORIZON | INDEMNITY | $759.84 | ↑ +195% |
| QUALCARE | WORKERS COMP | $764.88 | ↑ +197% |
| QUALCARE | HMO | $764.88 | ↑ +197% |
| QUALCARE | PPO | $764.88 | ↑ +197% |
| HORIZON | PPO | $767.60 | ↑ +198% |
| AMERIHEALTH | LOCAL HMO | $781.40 | ↑ +204% |
| AMERIHEALTH | REGIONAL HMO | $781.40 | ↑ +204% |
| OXFORD | ALL PRODUCTS | $2,958.00 | ↑ +1050% |
| UNITED HEALTHCARE | HMO | $3,667.00 | ↑ +1325% |
| AETNA | ASA | $4,025.00 | ↑ +1465% |
| AETNA | PPO | $4,025.00 | ↑ +1465% |
| AETNA | HMO | $4,025.00 | ↑ +1465% |
| HORIZON | WORKERS COMP | $8,173.00 | ↑ +3077% |
| HORIZON | PIP | $8,615.00 | ↑ +3249% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +3850% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of lip 40490 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Community Medical Center | Toms River | $3,786.00 | $30.94 – $505.04 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $29.85 – $518.45 |
| Bayshore Medical Center | Holmdel | $257.04 | $257.04 – $308.44 |
| Hackensack University Medical Center | Hackensack | $273.48 | $146.01 – $287.15 |
| Ocean University Medical Center | Brick | $253.79 | $141.57 – $304.55 |
| Jersey Shore University Medical Center | Neptune City | $257.04 | $141.57 – $308.44 |
| Palisades Medical Center | North Bergen | $273.48 | $146.01 – $298.09 |
| Raritan Bay Medical Center | Perth Amboy | $257.26 | $146.01 – $308.71 |