Lip exc/transverse wedge/w closure 40510 at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$3,592.74
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.
$5,977.00
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.
$365.42 with HORIZON vs $11,287.00 with UNITED HEALTHCARE — 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 | $365.42 | ↓ -90% |
| KARNA | MEDICARE ADVANTAGE | $759.10 | ↓ -79% |
| AETNA | MANAGED MEDICAID | $962.30 | ↓ -73% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,027.45 | ↓ -71% |
| CLOVER | MEDICARE ADVANTAGE | $1,075.86 | ↓ -70% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,285.06 | ↓ -64% |
| HORIZON | MEDICARE ADVANTAGE | $3,243.07 | ↓ -10% |
| AETNA | MEDICARE ADVANTAGE | $3,243.07 | ↓ -10% |
| WELLCARE | MEDICARE ADVANTAGE | $3,243.07 | ↓ -10% |
| AMERIGROUP | MEDICARE ADVANTAGE | $3,243.07 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $3,243.07 | ↓ -10% |
| VACCN | ALL PRODUCTS | $3,243.07 | ↓ -10% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,405.22 | ↓ -5% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,592.74 | ↑ +0% |
| AETNA | PPO | $4,025.00 | ↑ +12% |
| AETNA | HMO | $4,025.00 | ↑ +12% |
| AETNA | ASA | $4,025.00 | ↑ +12% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $4,183.90 | ↑ +16% |
| INTERGROUP | SHARED SAVINGS | $4,183.90 | ↑ +16% |
| INTERGROUP | WORKERS COMP | $4,183.90 | ↑ +16% |
| HORIZON | OMNIA | $4,397.88 | ↑ +22% |
| BERGEN RISK | ALL PRODUCTS | $4,482.75 | ↑ +25% |
| PRIME HEALTH | WORKERS COMP | $4,781.60 | ↑ +33% |
| PRIME HEALTH | AUTO INSURANCE | $4,781.60 | ↑ +33% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,080.45 | ↑ +41% |
| HORIZON | SHP | $5,243.02 | ↑ +46% |
| CIGNA | PPO | $5,408.59 | ↑ +51% |
| CIGNA | HMO | $5,408.59 | ↑ +51% |
| HORIZON | HMO | $5,426.52 | ↑ +51% |
| HORIZON | INDEMNITY | $5,498.24 | ↑ +53% |
| QUALCARE | PPO | $5,534.70 | ↑ +54% |
| QUALCARE | HMO | $5,534.70 | ↑ +54% |
| QUALCARE | WORKERS COMP | $5,534.70 | ↑ +54% |
| HORIZON | PPO | $5,554.43 | ↑ +55% |
| AMERIHEALTH | LOCAL HMO | $5,654.24 | ↑ +57% |
| AMERIHEALTH | REGIONAL HMO | $5,654.24 | ↑ +57% |
| HORIZON | WORKERS COMP | $8,173.00 | ↑ +127% |
| HORIZON | PIP | $8,615.00 | ↑ +140% |
| OXFORD | ALL PRODUCTS | $9,050.00 | ↑ +152% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +183% |
| UNITED HEALTHCARE | HMO | $11,287.00 | ↑ +214% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Lip exc/transverse wedge/w closure 40510 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $254.22 – $7,088.58 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $303.30 – $7,276.94 |
| Community Medical Center | Toms River | $3,786.00 | $310.61 – $7,053.14 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $299.64 – $7,240.56 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $261.70 – $7,276.94 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $328.88 – $7,600.27 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $599.29 – $7,143.34 |
| Bayshore Medical Center | Holmdel | $3,589.62 | $3,589.62 – $4,307.55 |