Nasal/sinus endo w/ethmoidectomy tot 31255 at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$7,668.85
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.
$12,296.00
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.
$400.00 with HORIZON vs $15,496.00 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 | $400.00 | ↓ -95% |
| KARNA | MEDICARE ADVANTAGE | $680.23 | ↓ -91% |
| AETNA | MANAGED MEDICAID | $1,979.66 | ↓ -74% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $2,113.68 | ↓ -72% |
| CLOVER | MEDICARE ADVANTAGE | $2,213.28 | ↓ -71% |
| AETNA | MEDICARE ADVANTAGE | $2,532.98 | ↓ -67% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $2,643.64 | ↓ -66% |
| AMERIGROUP | MEDICARE ADVANTAGE | $3,221.55 | ↓ -58% |
| HORIZON | MEDICARE ADVANTAGE | $6,922.47 | ↓ -10% |
| VACCN | ALL PRODUCTS | $6,922.47 | ↓ -10% |
| WELLCARE | MEDICARE ADVANTAGE | $6,922.47 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $6,922.47 | ↓ -10% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $7,268.59 | ↓ -5% |
| HORIZON | OMNIA | $7,564.00 | ↓ -1% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $7,668.85 | ↑ +0% |
| HORIZON | WORKERS COMP | $8,173.00 | ↑ +7% |
| INTERGROUP | SHARED SAVINGS | $8,607.20 | ↑ +12% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $8,607.20 | ↑ +12% |
| INTERGROUP | WORKERS COMP | $8,607.20 | ↑ +12% |
| HORIZON | PIP | $8,615.00 | ↑ +12% |
| HORIZON | SHP | $8,665.00 | ↑ +13% |
| QUALCARE | WORKERS COMP | $9,170.00 | ↑ +20% |
| CIGNA | HMO | $9,178.00 | ↑ +20% |
| BERGEN RISK | ALL PRODUCTS | $9,222.00 | ↑ +20% |
| QUALCARE | PPO | $9,342.00 | ↑ +22% |
| QUALCARE | HMO | $9,342.00 | ↑ +22% |
| HORIZON | HMO | $9,360.00 | ↑ +22% |
| HORIZON | INDEMNITY | $9,469.00 | ↑ +23% |
| HORIZON | PPO | $9,581.00 | ↑ +25% |
| PRIME HEALTH | AUTO INSURANCE | $9,836.80 | ↑ +28% |
| PRIME HEALTH | WORKERS COMP | $9,836.80 | ↑ +28% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +33% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $10,451.60 | ↑ +36% |
| BRIGHTON HEALTH PLAN | PNO | $10,655.47 | ↑ +39% |
| AETNA | ASA | $10,692.00 | ↑ +39% |
| AETNA | HMO | $10,692.00 | ↑ +39% |
| AETNA | PPO | $10,692.00 | ↑ +39% |
| AMERIHEALTH | LOCAL HMO | $10,711.00 | ↑ +40% |
| CIGNA | PPO | $10,771.00 | ↑ +40% |
| AMERIHEALTH | REGIONAL HMO | $11,632.02 | ↑ +52% |
| OXFORD | ALL PRODUCTS | $12,418.00 | ↑ +62% |
| UNITED HEALTHCARE | HMO | $15,496.00 | ↑ +102% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Nasal/sinus endo w/ethmoidectomy tot 31255 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $162.65 – $15,130.86 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $332.00 – $15,532.92 |
| Community Medical Center | Toms River | $3,786.00 | $340.00 – $15,055.21 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $328.00 – $15,455.26 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $167.43 – $15,532.92 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $210.49 – $16,223.12 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $656.00 – $15,247.80 |
| Bayshore Medical Center | Holmdel | $7,662.21 | $7,662.21 – $9,194.65 |