Reconstruct shoulder joint at JFK Johnson Rehabilitation Institute (JRI)
65 James Street, Edison, NJ · Hackensack Meridian Health · · NPI 1275107344
$20,372.87
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.
$24,441.00
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.
$1,967.00 with HORIZON vs $30,154.00 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 | $1,967.00 | ↓ -90% |
| KARNA | MEDICARE ADVANTAGE | $3,088.46 | ↓ -85% |
| AETNA | MANAGED MEDICAID | $3,935.00 | ↓ -81% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $4,201.41 | ↓ -79% |
| CLOVER | MEDICARE ADVANTAGE | $4,399.38 | ↓ -78% |
| AETNA | MEDICARE ADVANTAGE | $5,034.85 | ↓ -75% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $5,254.82 | ↓ -74% |
| AMERIGROUP | MEDICARE ADVANTAGE | $6,403.54 | ↓ -69% |
| HORIZON | OMNIA | $7,564.00 | ↓ -63% |
| HORIZON | WORKERS COMP | $8,173.00 | ↓ -60% |
| HORIZON | PIP | $8,615.00 | ↓ -58% |
| HORIZON | SHP | $8,665.00 | ↓ -57% |
| QUALCARE | WORKERS COMP | $9,170.00 | ↓ -55% |
| QUALCARE | HMO | $9,342.00 | ↓ -54% |
| QUALCARE | PPO | $9,342.00 | ↓ -54% |
| HORIZON | HMO | $9,360.00 | ↓ -54% |
| HORIZON | INDEMNITY | $9,469.00 | ↓ -54% |
| HORIZON | PPO | $9,581.00 | ↓ -53% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↓ -50% |
| AETNA | HMO | $10,692.00 | ↓ -48% |
| AETNA | PPO | $10,692.00 | ↓ -48% |
| AETNA | ASA | $10,692.00 | ↓ -48% |
| AMERIHEALTH | LOCAL HMO | $10,711.00 | ↓ -47% |
| AMERIHEALTH | REGIONAL HMO | $11,904.00 | ↓ -42% |
| CIGNA | HMO | $14,449.00 | ↓ -29% |
| CIGNA | PPO | $14,449.00 | ↓ -29% |
| BERGEN RISK | ALL PRODUCTS | $15,603.00 | ↓ -23% |
| INTERGROUP | SHARED SAVINGS | $17,108.70 | ↓ -16% |
| INTERGROUP | WORKERS COMP | $17,108.70 | ↓ -16% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $17,108.70 | ↓ -16% |
| WELLCARE | MEDICARE ADVANTAGE | $18,390.05 | ↓ -10% |
| HORIZON | MEDICARE ADVANTAGE | $18,390.05 | ↓ -10% |
| VACCN | ALL PRODUCTS | $18,390.05 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $18,390.05 | ↓ -10% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $19,309.55 | ↓ -5% |
| PRIME HEALTH | WORKERS COMP | $19,552.80 | ↓ -4% |
| PRIME HEALTH | AUTO INSURANCE | $19,552.80 | ↓ -4% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $20,372.87 | ↑ +0% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $20,774.85 | ↑ +2% |
| OXFORD | ALL PRODUCTS | $24,137.00 | ↑ +18% |
| UNITED HEALTHCARE | HMO | $30,154.00 | ↑ +48% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Reconstruct shoulder joint at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $736.99 – $40,196.24 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $20,632.16 – $41,264.32 |
| Community Medical Center | Toms River | $3,786.00 | $20,098.12 – $39,995.26 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $20,632.16 – $41,058.00 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $758.67 – $41,264.32 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $953.75 – $43,097.89 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $20,355.21 – $40,506.87 |
| Bayshore Medical Center | Holmdel | $20,355.21 | $20,355.21 – $24,426.25 |