Exc tendon sheath or cap lesion 26160 at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$1,772.97
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.
$4,575.00
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.
$255.42 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 | $255.42 | ↓ -86% |
| KARNA | MEDICARE ADVANTAGE | $705.08 | ↓ -60% |
| AETNA | MANAGED MEDICAID | $736.58 | ↓ -58% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $786.44 | ↓ -56% |
| CLOVER | MEDICARE ADVANTAGE | $823.50 | ↓ -54% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $983.63 | ↓ -45% |
| VACCN | ALL PRODUCTS | $1,600.41 | ↓ -10% |
| AMERIGROUP | MEDICARE ADVANTAGE | $1,600.41 | ↓ -10% |
| HORIZON | MEDICARE ADVANTAGE | $1,600.41 | ↓ -10% |
| AETNA | MEDICARE ADVANTAGE | $1,600.41 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $1,600.41 | ↓ -10% |
| WELLCARE | MEDICARE ADVANTAGE | $1,600.41 | ↓ -10% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,680.43 | ↓ -5% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,772.97 | ↑ +0% |
| INTERGROUP | WORKERS COMP | $3,202.50 | ↑ +81% |
| INTERGROUP | SHARED SAVINGS | $3,202.50 | ↑ +81% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $3,202.50 | ↑ +81% |
| HORIZON | OMNIA | $3,366.29 | ↑ +90% |
| BERGEN RISK | ALL PRODUCTS | $3,431.25 | ↑ +94% |
| PRIME HEALTH | WORKERS COMP | $3,660.00 | ↑ +106% |
| PRIME HEALTH | AUTO INSURANCE | $3,660.00 | ↑ +106% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $3,888.75 | ↑ +119% |
| HORIZON | SHP | $4,013.19 | ↑ +126% |
| CIGNA | HMO | $4,139.92 | ↑ +134% |
| CIGNA | PPO | $4,139.92 | ↑ +134% |
| HORIZON | HMO | $4,153.64 | ↑ +134% |
| HORIZON | INDEMNITY | $4,208.54 | ↑ +137% |
| QUALCARE | HMO | $4,236.45 | ↑ +139% |
| QUALCARE | WORKERS COMP | $4,236.45 | ↑ +139% |
| QUALCARE | PPO | $4,236.45 | ↑ +139% |
| HORIZON | PPO | $4,251.55 | ↑ +140% |
| AMERIHEALTH | LOCAL HMO | $4,327.95 | ↑ +144% |
| AMERIHEALTH | REGIONAL HMO | $4,327.95 | ↑ +144% |
| OXFORD | ALL PRODUCTS | $6,730.00 | ↑ +280% |
| HORIZON | WORKERS COMP | $8,173.00 | ↑ +361% |
| UNITED HEALTHCARE | HMO | $8,385.00 | ↑ +373% |
| HORIZON | PIP | $8,615.00 | ↑ +386% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +473% |
| AETNA | PPO | $10,692.00 | ↑ +503% |
| AETNA | HMO | $10,692.00 | ↑ +503% |
| AETNA | ASA | $10,692.00 | ↑ +503% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Exc tendon sheath or cap lesion 26160 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $64.46 – $3,498.12 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $212.00 – $3,591.06 |
| Community Medical Center | Toms River | $3,786.00 | $217.11 – $3,480.63 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $209.44 – $3,573.10 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $66.36 – $3,591.06 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $83.42 – $3,750.63 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $418.89 – $3,525.15 |
| Bayshore Medical Center | Holmdel | $1,771.43 | $1,771.43 – $2,125.72 |