Biopsy of salivary glnd;incisional 42405 at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$1,640.99
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.
$5,304.00
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.
$81.20 with HORIZON vs $10,692.00 with AETNA — 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 | $81.20 | ↓ -95% |
| KARNA | MEDICARE ADVANTAGE | $490.93 | ↓ -70% |
| AETNA | MANAGED MEDICAID | $853.94 | ↓ -48% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $911.76 | ↓ -44% |
| CLOVER | MEDICARE ADVANTAGE | $954.72 | ↓ -42% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,140.36 | ↓ -31% |
| VACCN | ALL PRODUCTS | $1,481.28 | ↓ -10% |
| AMERIGROUP | MEDICARE ADVANTAGE | $1,481.28 | ↓ -10% |
| HORIZON | MEDICARE ADVANTAGE | $1,481.28 | ↓ -10% |
| AETNA | MEDICARE ADVANTAGE | $1,481.28 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $1,481.28 | ↓ -10% |
| WELLCARE | MEDICARE ADVANTAGE | $1,481.28 | ↓ -10% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,555.34 | ↓ -5% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,640.99 | ↑ +0% |
| INTERGROUP | WORKERS COMP | $3,712.80 | ↑ +126% |
| INTERGROUP | SHARED SAVINGS | $3,712.80 | ↑ +126% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $3,712.80 | ↑ +126% |
| HORIZON | OMNIA | $3,902.68 | ↑ +138% |
| BERGEN RISK | ALL PRODUCTS | $3,978.00 | ↑ +142% |
| PRIME HEALTH | WORKERS COMP | $4,243.20 | ↑ +159% |
| PRIME HEALTH | AUTO INSURANCE | $4,243.20 | ↑ +159% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,508.40 | ↑ +175% |
| HORIZON | SHP | $4,652.67 | ↑ +184% |
| CIGNA | HMO | $4,799.59 | ↑ +192% |
| CIGNA | PPO | $4,799.59 | ↑ +192% |
| HORIZON | HMO | $4,815.50 | ↑ +193% |
| HORIZON | INDEMNITY | $4,879.15 | ↑ +197% |
| QUALCARE | HMO | $4,911.50 | ↑ +199% |
| QUALCARE | WORKERS COMP | $4,911.50 | ↑ +199% |
| QUALCARE | PPO | $4,911.50 | ↑ +199% |
| HORIZON | PPO | $4,929.01 | ↑ +200% |
| AMERIHEALTH | LOCAL HMO | $5,017.58 | ↑ +206% |
| AMERIHEALTH | REGIONAL HMO | $5,017.58 | ↑ +206% |
| OXFORD | ALL PRODUCTS | $6,730.00 | ↑ +310% |
| HORIZON | WORKERS COMP | $8,173.00 | ↑ +398% |
| UNITED HEALTHCARE | HMO | $8,385.00 | ↑ +411% |
| HORIZON | PIP | $8,615.00 | ↑ +425% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +519% |
| AETNA | PPO | $10,692.00 | ↑ +552% |
| AETNA | HMO | $10,692.00 | ↑ +552% |
| AETNA | ASA | $10,692.00 | ↑ +552% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of salivary glnd;incisional 42405 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $31.59 – $3,237.72 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $67.40 – $3,323.76 |
| Community Medical Center | Toms River | $3,786.00 | $69.02 – $3,221.53 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $66.58 – $3,307.14 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $32.52 – $3,323.76 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $40.88 – $3,471.44 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $133.17 – $3,262.74 |
| Bayshore Medical Center | Holmdel | $1,639.57 | $1,639.57 – $1,967.48 |