healthcosts.net
Ortho elbow w/lock w/ft&adj 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.
$728.00
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.
$131.04 with CLOVER vs $848.34 with KARNA — 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 |
|---|---|---|---|
| CLOVER | MEDICARE ADVANTAGE | $131.04 | — |
| AETNA | MEDICARE ADVANTAGE | $149.97 | — |
| CIGNA | HMO | $262.08 | — |
| CIGNA | PPO | $262.08 | — |
| HORIZON | MANAGED MEDICAID | $277.37 | — |
| WELLCARE | MEDICARE ADVANTAGE | $327.60 | — |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $364.00 | — |
| HORIZON | HMO | $364.00 | — |
| HORIZON | INDEMNITY | $364.00 | — |
| HORIZON | OMNIA | $364.00 | — |
| HORIZON | PPO | $364.00 | — |
| HORIZON | SHP | $364.00 | — |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $364.00 | — |
| OXFORD - JRI@OUMC | ALL PRODUCTS | $366.18 | — |
| UNITED HEALTHCARE - JRI@OUMC | ALL PRODUCTS | $406.95 | — |
| WELLCARE | MANAGED MEDICAID | $423.48 | — |
| BERGEN RISK | ALL PRODUCTS | $436.80 | — |
| AETNA | HMO | $438.86 | — |
| AETNA | ASA | $438.86 | — |
| AETNA | PPO | $438.86 | — |
| INTERGROUP | WORKERS COMP | $509.60 | — |
| INTERGROUP | SHARED SAVINGS | $509.60 | — |
| BRIGHTON HEALTH PLAN | PNO | $509.60 | — |
| AMERIHEALTH | LOCAL HMO | $565.97 | — |
| AMERIHEALTH | REGIONAL HMO | $565.97 | — |
| PRIME HEALTH | WORKERS COMP | $582.40 | — |
| PRIME HEALTH | AUTO INSURANCE | $582.40 | — |
| MULTIPLAN - PHCS | ALL PRODUCTS | $618.80 | — |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $728.00 | — |
| BRIGHTON HEALTH PLAN - JRI@OUMC | ALL PRODUCTS | $728.00 | — |
| KARNA | MEDICARE ADVANTAGE | $848.34 | — |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | not published by hospital | — |
| VACCN | ALL PRODUCTS | not published by hospital | — |