Clsd tx/prox/mid phalnx fx/no manp 26720 at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$265.74
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.
$1,225.00
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.
$99.00 with HORIZON vs $4,025.00 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 | $99.00 | ↓ -63% |
| AETNA | MANAGED MEDICAID | $197.23 | ↓ -26% |
| CLOVER | MEDICARE ADVANTAGE | $220.50 | ↓ -17% |
| WELLCARE | MEDICARE ADVANTAGE | $239.88 | ↓ -10% |
| AETNA | MEDICARE ADVANTAGE | $239.88 | ↓ -10% |
| AMERIGROUP | MEDICARE ADVANTAGE | $239.88 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $239.88 | ↓ -10% |
| VACCN | ALL PRODUCTS | $239.88 | ↓ -10% |
| HORIZON | MEDICARE ADVANTAGE | $239.88 | ↓ -10% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $251.87 | ↓ -5% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $263.38 | ↓ -1% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $265.74 | ↑ +0% |
| KARNA | MEDICARE ADVANTAGE | $435.75 | ↑ +64% |
| INTERGROUP | WORKERS COMP | $857.50 | ↑ +223% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $857.50 | ↑ +223% |
| INTERGROUP | SHARED SAVINGS | $857.50 | ↑ +223% |
| PRIME HEALTH | AUTO INSURANCE | $980.00 | ↑ +269% |
| PRIME HEALTH | WORKERS COMP | $980.00 | ↑ +269% |
| OXFORD | ALL PRODUCTS | $1,014.06 | ↑ +282% |
| UNITED HEALTHCARE | HMO | $1,018.59 | ↑ +283% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $1,041.25 | ↑ +292% |
| QUALCARE | PPO | $1,134.35 | ↑ +327% |
| QUALCARE | WORKERS COMP | $1,134.35 | ↑ +327% |
| QUALCARE | HMO | $1,134.35 | ↑ +327% |
| HORIZON | WORKERS COMP | $1,312.00 | ↑ +394% |
| HORIZON | PIP | $2,615.00 | ↑ +884% |
| AETNA | PPO | $4,025.00 | ↑ +1415% |
| AETNA | ASA | $4,025.00 | ↑ +1415% |
| AETNA | HMO | $4,025.00 | ↑ +1415% |
| HORIZON | SHP | not published by hospital | — |
| HORIZON | PPO | not published by hospital | — |
| HORIZON | OMNIA | not published by hospital | — |
| HORIZON | INDEMNITY | not published by hospital | — |
| HORIZON | HMO | not published by hospital | — |
| CIGNA | PPO | not published by hospital | — |
| CIGNA | HMO | not published by hospital | — |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | not published by hospital | — |
| BERGEN RISK | ALL PRODUCTS | not published by hospital | — |
| UNITED HEALTHCARE | MANAGED MEDICAID | not published by hospital | — |
| AMERIHEALTH | REGIONAL HMO | not published by hospital | — |
| AMERIHEALTH | LOCAL HMO | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx/prox/mid phalnx fx/no manp 26720 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Community Medical Center | Toms River | $3,786.00 | $84.15 – $521.70 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $81.18 – $535.57 |
| Bayshore Medical Center | Holmdel | $265.51 | $265.51 – $368.00 |
| Hackensack University Medical Center | Hackensack | $282.50 | $226.00 – $435.75 |
| Ocean University Medical Center | Brick | $262.16 | $239.88 – $417.66 |
| Jersey Shore University Medical Center | Neptune City | $265.51 | $265.51 – $417.66 |
| Palisades Medical Center | North Bergen | $282.50 | $282.50 – $435.75 |
| Raritan Bay Medical Center | Perth Amboy | $265.74 | $123.75 – $795.00 |