Drng of mouth lesion 40801 at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$564.16
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.
$1,641.00
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.
$111.32 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 | $111.32 | ↓ -80% |
| AETNA | MANAGED MEDICAID | $264.20 | ↓ -53% |
| CLOVER | MEDICARE ADVANTAGE | $295.38 | ↓ -48% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $352.82 | ↓ -37% |
| KARNA | MEDICARE ADVANTAGE | $431.17 | ↓ -24% |
| AETNA | MEDICARE ADVANTAGE | $509.25 | ↓ -10% |
| WELLCARE | MEDICARE ADVANTAGE | $509.25 | ↓ -10% |
| VACCN | ALL PRODUCTS | $509.25 | ↓ -10% |
| AMERIGROUP | MEDICARE ADVANTAGE | $509.25 | ↓ -10% |
| HORIZON | MEDICARE ADVANTAGE | $509.25 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $509.25 | ↓ -10% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $534.71 | ↓ -5% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $564.16 | ↑ +0% |
| INTERGROUP | SHARED SAVINGS | $1,148.70 | ↑ +104% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $1,148.70 | ↑ +104% |
| INTERGROUP | WORKERS COMP | $1,148.70 | ↑ +104% |
| HORIZON | WORKERS COMP | $1,312.00 | ↑ +133% |
| PRIME HEALTH | WORKERS COMP | $1,312.80 | ↑ +133% |
| PRIME HEALTH | AUTO INSURANCE | $1,312.80 | ↑ +133% |
| OXFORD | ALL PRODUCTS | $1,358.42 | ↑ +141% |
| UNITED HEALTHCARE | HMO | $1,364.49 | ↑ +142% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $1,394.85 | ↑ +147% |
| QUALCARE | WORKERS COMP | $1,519.57 | ↑ +169% |
| QUALCARE | HMO | $1,519.57 | ↑ +169% |
| QUALCARE | PPO | $1,519.57 | ↑ +169% |
| HORIZON | PIP | $2,615.00 | ↑ +364% |
| 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
Drng of mouth lesion 40801 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $151.05 – $1,113.10 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $92.40 – $1,142.68 |
| Community Medical Center | Toms River | $3,786.00 | $94.62 – $1,107.53 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $91.28 – $1,136.97 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $155.49 – $1,142.68 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $100.19 – $1,193.44 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $182.56 – $1,121.70 |
| Bayshore Medical Center | Holmdel | $563.67 | $368.00 – $676.40 |