Drainage mouth roof lesion 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.
$721.00
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.
$43.56 with HORIZON vs $2,615.00 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 |
|---|---|---|---|
| HORIZON | MANAGED MEDICAID | $43.56 | ↓ -83% |
| AETNA | MANAGED MEDICAID | $116.08 | ↓ -55% |
| CLOVER | MEDICARE ADVANTAGE | $129.78 | ↓ -50% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $155.02 | ↓ -40% |
| HORIZON | MEDICARE ADVANTAGE | $232.22 | ↓ -10% |
| AETNA | MEDICARE ADVANTAGE | $232.22 | ↓ -10% |
| WELLCARE | MEDICARE ADVANTAGE | $232.22 | ↓ -10% |
| VACCN | ALL PRODUCTS | $232.22 | ↓ -10% |
| AMERIGROUP | MEDICARE ADVANTAGE | $232.22 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $232.22 | ↓ -10% |
| KARNA | MEDICARE ADVANTAGE | $239.52 | ↓ -7% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $243.83 | ↓ -5% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $257.26 | ↑ +0% |
| INTERGROUP | SHARED SAVINGS | $504.70 | ↑ +96% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $504.70 | ↑ +96% |
| INTERGROUP | WORKERS COMP | $504.70 | ↑ +96% |
| PRIME HEALTH | WORKERS COMP | $576.80 | ↑ +124% |
| PRIME HEALTH | AUTO INSURANCE | $576.80 | ↑ +124% |
| OXFORD | ALL PRODUCTS | $596.84 | ↑ +132% |
| UNITED HEALTHCARE | HMO | $599.51 | ↑ +133% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $612.85 | ↑ +138% |
| QUALCARE | WORKERS COMP | $667.65 | ↑ +160% |
| QUALCARE | HMO | $667.65 | ↑ +160% |
| QUALCARE | PPO | $667.65 | ↑ +160% |
| HORIZON | WORKERS COMP | $1,312.00 | ↑ +410% |
| HORIZON | PIP | $2,615.00 | ↑ +916% |
| HORIZON | PPO | not published by hospital | — |
| AETNA | ASA | not published by hospital | — |
| AETNA | HMO | not published by hospital | — |
| AETNA | PPO | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| AMERIHEALTH | LOCAL HMO | not published by hospital | — |
| AMERIHEALTH | REGIONAL HMO | not published by hospital | — |
| BERGEN RISK | ALL PRODUCTS | not published by hospital | — |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | not published by hospital | — |
| CIGNA | HMO | not published by hospital | — |
| CIGNA | PPO | not published by hospital | — |
| HORIZON | HMO | not published by hospital | — |
| HORIZON | INDEMNITY | not published by hospital | — |
| HORIZON | OMNIA | not published by hospital | — |
| HORIZON | SHP | not published by hospital | — |
| UNITED HEALTHCARE | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Drainage mouth roof lesion at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Community Medical Center | Toms River | $3,786.00 | $37.03 – $505.04 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $35.72 – $518.45 |
| Bayshore Medical Center | Holmdel | $257.04 | $257.04 – $368.00 |
| Hackensack University Medical Center | Hackensack | $273.48 | $218.78 – $287.15 |
| Ocean University Medical Center | Brick | $253.79 | $230.32 – $368.00 |
| Jersey Shore University Medical Center | Neptune City | $257.04 | $230.32 – $308.44 |
| Palisades Medical Center | North Bergen | $273.48 | $239.52 – $298.09 |
| Raritan Bay Medical Center | Perth Amboy | $257.26 | $54.45 – $795.00 |