healthcosts.net
Tonsillectomy (age 12+) at Hackensack University Medical Center
30 Prospect Avenue, Hackensack, NJ · Hackensack Meridian Health · · NPI 1457456279
$3,819.23
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.
$7,186.00
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.
$559.42 with KARNA vs $16,802.00 with HORIZON — 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 |
|---|---|---|---|
| KARNA | MEDICARE ADVANTAGE | $559.42 | ↓ -85% |
| CLOVER | MEDICARE ADVANTAGE | $1,293.48 | ↓ -66% |
| AETNA | MANAGED MEDICAID | $1,803.69 | ↓ -53% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $2,055.20 | ↓ -46% |
| HORIZON | MANAGED MEDICAID | $2,728.00 | ↓ -29% |
| OPTUM HEALTH | MANAGED MEDICAID | $3,055.39 | ↓ -20% |
| LHP HEALTH | ALL PRODUCTS | $3,548.00 | ↓ -7% |
| AETNA | MEDICARE ADVANTAGE | $3,723.23 | ↓ -3% |
| OPTUM HEALTH | MEDICARE ADVANTAGE | $3,819.23 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,819.23 | ↑ +0% |
| HORIZON | MEDICARE ADVANTAGE | $3,819.23 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,819.23 | ↑ +0% |
| VACCN | ALL PRODUCTS | $3,819.23 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,819.23 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,010.20 | ↑ +5% |
| HORIZON | OMNIA | $4,706.11 | ↑ +23% |
| INTERGROUP | ALL PRODUCTS | $5,030.20 | ↑ +32% |
| HORIZON | PIP | $5,389.50 | ↑ +41% |
| BERGEN RISK | ALL PRODUCTS | $5,389.50 | ↑ +41% |
| CIGNA | BH | $5,748.80 | ↑ +51% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $6,108.10 | ↑ +60% |
| CHN | ALL PRODUCTS | $6,108.10 | ↑ +60% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $6,108.10 | ↑ +60% |
| QUALCARE | WORKERS COMP | $6,395.54 | ↑ +67% |
| QUALCARE | PPO | $6,395.54 | ↑ +67% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $6,467.40 | ↑ +69% |
| CIGNA | PPO | $6,534.95 | ↑ +71% |
| CIGNA | HMO | $6,534.95 | ↑ +71% |
| HORIZON | HMO | $6,843.95 | ↑ +79% |
| HORIZON | INDEMNITY | $6,879.16 | ↑ +80% |
| HORIZON | SHP | $6,922.99 | ↑ +81% |
| HORIZON | FEDERAL | $7,007.79 | ↑ +83% |
| HORIZON | PPO | $7,007.79 | ↑ +83% |
| QUALCARE | HMO | $7,712.00 | ↑ +102% |
| AETNA | PPO | $7,773.00 | ↑ +104% |
| AETNA | ASA | $7,773.00 | ↑ +104% |
| AETNA | HMO | $7,773.00 | ↑ +104% |
| AMERIHEALTH | LOCAL HMO | $8,013.00 | ↑ +110% |
| AMERIHEALTH | REGIONAL HMO | $8,904.00 | ↑ +133% |
| OXFORD | ALL PRODUCTS | $9,571.00 | ↑ +151% |
| UNITED HEALTHCARE | HMO | $11,528.00 | ↑ +202% |
| HORIZON | WORKERS COMP | $16,802.00 | ↑ +340% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Tonsillectomy (age 12+) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $3,589.62 | $915.12 – $4,794.34 |
| Ocean University Medical Center | Brick | $3,544.29 | $539.41 – $6,502.61 |