healthcosts.net
Excise sublingual gland at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$5,915.66
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.
$10,544.00
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.
$795.66 with KARNA 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 |
|---|---|---|---|
| KARNA | MEDICARE ADVANTAGE | $795.66 | ↓ -87% |
| HORIZON | MANAGED MEDICAID | $1,967.00 | ↓ -67% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $2,266.96 | ↓ -62% |
| AETNA | MEDICARE ADVANTAGE | $5,915.66 | ↑ +0% |
| AMERIGROUP | MEDICARE ADVANTAGE | $5,915.66 | ↑ +0% |
| HORIZON | MEDICARE ADVANTAGE | $5,915.66 | ↑ +0% |
| VACCN | ALL PRODUCTS | $5,915.66 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $5,915.66 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $5,915.66 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $6,211.44 | ↑ +5% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $7,380.80 | ↑ +25% |
| INTERGROUP | SHARED SAVINGS | $7,380.80 | ↑ +25% |
| INTERGROUP | WORKERS COMP | $7,380.80 | ↑ +25% |
| BERGEN RISK | ALL PRODUCTS | $7,908.00 | ↑ +34% |
| PRIME HEALTH | AUTO INSURANCE | $8,435.20 | ↑ +43% |
| PRIME HEALTH | WORKERS COMP | $8,435.20 | ↑ +43% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $8,962.40 | ↑ +52% |
| CIGNA | HMO | $9,178.00 | ↑ +55% |
| CIGNA | PPO | $9,541.27 | ↑ +61% |
| AETNA | ASA | $10,692.00 | ↑ +81% |
| AETNA | HMO | $10,692.00 | ↑ +81% |
| AETNA | PPO | $10,692.00 | ↑ +81% |