Biopsy of lip 40490 at Trinitas Regional Medical Center
225 Williamson St, Elizabeth, NJ · RWJBarnabas Health · · NPI 1770583999
$5,855.00
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.
not published by hospital
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.
$12.65 with Wellpoint vs $3,236.00 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 |
|---|---|---|---|
| Wellpoint | NJ Family Care | $12.65 | ↓ -100% |
| Humana | Medicare | $253.79 | ↓ -96% |
| Wellpoint | Medicare Advantage | $253.79 | ↓ -96% |
| Aetna | Medicare | $253.79 | ↓ -96% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $253.79 | ↓ -96% |
| Fidelis Care | Medicare Advantage | $253.79 | ↓ -96% |
| Clover Health | Medicare Advantage | $253.79 | ↓ -96% |
| United Healthcare | Medicare | $258.87 | ↓ -96% |
| Amerihealth | Local Value | $380.41 | ↓ -94% |
| Amerihealth | Regional Preferred | $380.41 | ↓ -94% |
| Wellcare | Ambetter Health Commercial | $505.04 | ↓ -91% |
| Emblem Health | Commercial | $507.58 | ↓ -91% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $636.71 | ↓ -89% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $1,003.05 | ↓ -83% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $1,049.90 | ↓ -82% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $1,062.01 | ↓ -82% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $1,693.84 | ↓ -71% |
| Cigna | HMO | $1,930.00 | ↓ -67% |
| Cigna | PPO | $2,033.00 | ↓ -65% |
| United Healthcare | Oxford Metro | $2,445.00 | ↓ -58% |
| Aetna | PPO | $2,612.00 | ↓ -55% |
| Aetna | HMO | $2,612.00 | ↓ -55% |
| United Healthcare | Nexus | $2,751.00 | ↓ -53% |
| United Healthcare | Oxford Commercial | $2,877.00 | ↓ -51% |
| United Healthcare | Commercial | $3,236.00 | ↓ -45% |
| Qualcare Inc | HMO/POS/PPO/WC | not published by hospital | — |
| Aetna | Better Health | not published by hospital | — |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | not published by hospital | — |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | not published by hospital | — |
| United Healthcare | Community Plan | not published by hospital | — |
| First Health | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of lip 40490 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $257.04 | $257.04 – $308.44 |
| Hackensack University Medical Center | Hackensack | $273.48 | $146.01 – $287.15 |
| Ocean University Medical Center | Brick | $253.79 | $141.57 – $304.55 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $257.26 | $36.40 – $257.26 |
| Jersey Shore University Medical Center | Neptune City | $257.04 | $141.57 – $308.44 |
| Palisades Medical Center | North Bergen | $273.48 | $146.01 – $298.09 |
| Raritan Bay Medical Center | Perth Amboy | $257.26 | $146.01 – $308.71 |
| Riverview Medical Center | Red Bank | $257.04 | $141.57 – $308.44 |