Nasal/sinus endoscopy surg w/bx 31237 at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$1,910.40
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.
$4,168.00
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.
$172.00 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 | $172.00 | ↓ -91% |
| KARNA | MEDICARE ADVANTAGE | $340.46 | ↓ -82% |
| AETNA | MANAGED MEDICAID | $671.05 | ↓ -65% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $716.48 | ↓ -62% |
| CLOVER | MEDICARE ADVANTAGE | $750.24 | ↓ -61% |
| AETNA | MEDICARE ADVANTAGE | $858.61 | ↓ -55% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $896.12 | ↓ -53% |
| AMERIGROUP | MEDICARE ADVANTAGE | $1,092.02 | ↓ -43% |
| HORIZON | MEDICARE ADVANTAGE | $1,724.47 | ↓ -10% |
| WELLCARE | MEDICARE ADVANTAGE | $1,724.47 | ↓ -10% |
| VACCN | ALL PRODUCTS | $1,724.47 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $1,724.47 | ↓ -10% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,810.69 | ↓ -5% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,910.40 | ↑ +0% |
| BRIGHTON HEALTH PLAN | PNO | $2,834.43 | ↑ +48% |
| INTERGROUP | WORKERS COMP | $2,917.60 | ↑ +53% |
| INTERGROUP | SHARED SAVINGS | $2,917.60 | ↑ +53% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $2,917.60 | ↑ +53% |
| HORIZON | OMNIA | $3,066.81 | ↑ +61% |
| BERGEN RISK | ALL PRODUCTS | $3,126.00 | ↑ +64% |
| PRIME HEALTH | WORKERS COMP | $3,334.40 | ↑ +75% |
| PRIME HEALTH | AUTO INSURANCE | $3,334.40 | ↑ +75% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $3,542.80 | ↑ +85% |
| HORIZON | SHP | $3,656.17 | ↑ +91% |
| CIGNA | HMO | $3,771.62 | ↑ +97% |
| CIGNA | PPO | $3,771.62 | ↑ +97% |
| HORIZON | HMO | $3,784.13 | ↑ +98% |
| HORIZON | INDEMNITY | $3,834.14 | ↑ +101% |
| QUALCARE | HMO | $3,859.57 | ↑ +102% |
| QUALCARE | WORKERS COMP | $3,859.57 | ↑ +102% |
| QUALCARE | PPO | $3,859.57 | ↑ +102% |
| HORIZON | PPO | $3,873.32 | ↑ +103% |
| AMERIHEALTH | LOCAL HMO | $3,942.93 | ↑ +106% |
| AMERIHEALTH | REGIONAL HMO | $3,942.93 | ↑ +106% |
| OXFORD | ALL PRODUCTS | $6,730.00 | ↑ +252% |
| HORIZON | WORKERS COMP | $8,173.00 | ↑ +328% |
| UNITED HEALTHCARE | HMO | $8,385.00 | ↑ +339% |
| HORIZON | PIP | $8,615.00 | ↑ +351% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +432% |
| AETNA | PPO | $10,692.00 | ↑ +460% |
| AETNA | HMO | $10,692.00 | ↑ +460% |
| AETNA | ASA | $10,692.00 | ↑ +460% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Nasal/sinus endoscopy surg w/bx 31237 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $132.95 – $3,769.28 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $142.76 – $3,869.44 |
| Community Medical Center | Toms River | $3,786.00 | $146.20 – $3,750.43 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $141.04 – $3,850.09 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $136.86 – $3,869.44 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $154.80 – $4,041.37 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $282.08 – $3,798.41 |
| Bayshore Medical Center | Holmdel | $1,908.75 | $1,908.75 – $2,290.50 |