Pt evaluation moderate complexity patient/family at Hackensack University Medical Center
30 Prospect Avenue, Hackensack, NJ · Hackensack Meridian Health · · NPI 1457456279
$126.19
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.
$561.00
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.
$54.05 with HORIZON vs $899.20 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 | $54.05 | ↓ -57% |
| OPTUM HEALTH | MANAGED MEDICAID | $100.95 | ↓ -20% |
| CLOVER | MEDICARE ADVANTAGE | $100.98 | ↓ -20% |
| AETNA | MEDICARE ADVANTAGE | $126.19 | ↑ +0% |
| VACCN | ALL PRODUCTS | $126.19 | ↑ +0% |
| AMERIGROUP | MANAGED MEDICAID | $126.19 | ↑ +0% |
| HORIZON | MEDICARE ADVANTAGE | $126.19 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $126.19 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $126.19 | ↑ +0% |
| OPTUM HEALTH | MEDICARE ADVANTAGE | $126.19 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $126.19 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $132.50 | ↑ +5% |
| AETNA | MANAGED MEDICAID | $140.81 | ↑ +12% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $160.45 | ↑ +27% |
| KARNA | MEDICARE ADVANTAGE | $172.59 | ↑ +37% |
| CIGNA | HMO | $238.00 | ↑ +89% |
| CIGNA | PPO | $238.00 | ↑ +89% |
| OXFORD | ALL PRODUCTS | $346.00 | ↑ +174% |
| BERGEN RISK | ALL PRODUCTS | $349.00 | ↑ +177% |
| HORIZON | OMNIA | $367.40 | ↑ +191% |
| HORIZON | WORKERS COMP | $386.30 | ↑ +206% |
| INTERGROUP | ALL PRODUCTS | $392.70 | ↑ +211% |
| UNITED HEALTHCARE | HMO | $406.00 | ↑ +222% |
| HORIZON | PIP | $420.75 | ↑ +233% |
| LHP HEALTH | ALL PRODUCTS | $443.19 | ↑ +251% |
| CIGNA | BH | $448.80 | ↑ +256% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $476.85 | ↑ +278% |
| CHN | ALL PRODUCTS | $476.85 | ↑ +278% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $476.85 | ↑ +278% |
| QUALCARE | HMO | $494.80 | ↑ +292% |
| QUALCARE | WORKERS COMP | $494.80 | ↑ +292% |
| QUALCARE | PPO | $494.80 | ↑ +292% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $504.90 | ↑ +300% |
| HORIZON | HMO | $534.30 | ↑ +323% |
| HORIZON | INDEMNITY | $537.05 | ↑ +326% |
| HORIZON | SHP | $540.47 | ↑ +328% |
| HORIZON | FEDERAL | $547.09 | ↑ +334% |
| HORIZON | PPO | $547.09 | ↑ +334% |
| AMERIHEALTH | LOCAL HMO | $561.00 | ↑ +345% |
| AMERIHEALTH | REGIONAL HMO | $561.00 | ↑ +345% |
| AETNA | ASA | $899.20 | ↑ +613% |
| AETNA | PPO | $899.20 | ↑ +613% |
| AETNA | HMO | $899.20 | ↑ +613% |
Visitor-reported prices
Comments
Pt evaluation moderate complexity patient/family at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Carrier Clinic | Belle Mead | $181.20 | $65.69 – $65.69 |
| Saint Barnabas Behavioral Health Center | Toms River | $76.26 | not published |
| Childrens Specialized Hospital | Mountainside | $340.00 | $237.00 – $394.00 |
| Bayshore Medical Center | Holmdel | $126.19 | $126.19 – $517.00 |
| Ocean University Medical Center | Brick | $126.19 | $60.00 – $517.00 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $126.19 | $60.00 – $523.00 |
| Jersey Shore University Medical Center | Neptune City | $126.19 | $80.00 – $561.00 |
| Palisades Medical Center | North Bergen | $126.19 | $118.00 – $558.00 |