healthcosts.net
Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 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.
$1,925.00
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.
$105.30 with KARNA vs $1,741.93 with CIGNA — 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 | $105.30 | — |
| AETNA | MEDICARE ADVANTAGE | $396.55 | — |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $413.88 | — |
| OXFORD - JRI@OUMC | ALL PRODUCTS | $968.28 | — |
| UNITED HEALTHCARE - JRI@OUMC | ALL PRODUCTS | $1,076.08 | — |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $1,347.50 | — |
| INTERGROUP | SHARED SAVINGS | $1,347.50 | — |
| INTERGROUP | WORKERS COMP | $1,347.50 | — |
| PRIME HEALTH | AUTO INSURANCE | $1,540.00 | — |
| PRIME HEALTH | WORKERS COMP | $1,540.00 | — |
| MULTIPLAN - PHCS | ALL PRODUCTS | $1,636.25 | — |
| AETNA | ASA | $1,726.15 | — |
| AETNA | HMO | $1,726.15 | — |
| AETNA | PPO | $1,726.15 | — |
| CIGNA | HMO | $1,741.93 | — |
| CIGNA | PPO | $1,741.93 | — |
| WELLCARE | MEDICARE ADVANTAGE | not published by hospital | — |
| WELLCARE | MANAGED MEDICAID | not published by hospital | — |
| VACCN | ALL PRODUCTS | not published by hospital | — |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | not published by hospital | — |