Excision addl breast lesion 19126 at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
not published by hospital
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.
$4,753.00
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.
$156.98 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 | $156.98 | — |
| KARNA | MEDICARE ADVANTAGE | $333.40 | — |
| AETNA | MANAGED MEDICAID | $765.23 | — |
| UNITED HEALTHCARE | MANAGED MEDICAID | $817.04 | — |
| CLOVER | MEDICARE ADVANTAGE | $855.54 | — |
| AETNA | MEDICARE ADVANTAGE | $979.12 | — |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,021.90 | — |
| AMERIGROUP | MEDICARE ADVANTAGE | $1,245.29 | — |
| OXFORD | ALL PRODUCTS | $2,958.00 | — |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $3,327.10 | — |
| INTERGROUP | SHARED SAVINGS | $3,327.10 | — |
| INTERGROUP | WORKERS COMP | $3,327.10 | — |
| HORIZON | OMNIA | $3,497.26 | — |
| BERGEN RISK | ALL PRODUCTS | $3,564.75 | — |
| UNITED HEALTHCARE | HMO | $3,667.00 | — |
| PRIME HEALTH | AUTO INSURANCE | $3,802.40 | — |
| PRIME HEALTH | WORKERS COMP | $3,802.40 | — |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,040.05 | — |
| HORIZON | SHP | $4,169.33 | — |
| CIGNA | PPO | $4,300.99 | — |
| CIGNA | HMO | $4,300.99 | — |
| HORIZON | HMO | $4,315.25 | — |
| HORIZON | INDEMNITY | $4,372.28 | — |
| QUALCARE | WORKERS COMP | $4,401.28 | — |
| QUALCARE | PPO | $4,401.28 | — |
| QUALCARE | HMO | $4,401.28 | — |
| HORIZON | PPO | $4,416.96 | — |
| AMERIHEALTH | REGIONAL HMO | $4,496.34 | — |
| AMERIHEALTH | LOCAL HMO | $4,496.34 | — |
| HORIZON | WORKERS COMP | $8,173.00 | — |
| HORIZON | PIP | $8,615.00 | — |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | — |
| AETNA | HMO | $10,692.00 | — |
| AETNA | ASA | $10,692.00 | — |
| AETNA | PPO | $10,692.00 | — |
| VACCN | ALL PRODUCTS | not published by hospital | — |
| WELLCARE | MANAGED MEDICAID | not published by hospital | — |
| WELLCARE | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| HORIZON | MEDICARE ADVANTAGE | not published by hospital | — |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | not published by hospital | — |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Excision addl breast lesion 19126 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | not published | $80.28 – $1,978.15 |
| Cooperman Barnabas Medical Center | Livingston | not published | $130.29 – $130.29 |
| Community Medical Center | Toms River | not published | $133.43 – $133.43 |
| Clara Maass Medical Center | Belleville | not published | $128.72 – $128.72 |
| Newark Beth Israel Medical Center | Newark | not published | $82.65 – $236.25 |
| Jersey City Medical Center | Jersey City | not published | $103.90 – $141.28 |
| Monmouth Medical Center | Long Branch | not published | $257.45 – $257.45 |
| Bayshore Medical Center | Holmdel | not published | not published |