healthcosts.net
Tonsillectomy (child under 12) at Hackensack University Medical Center
30 Prospect Avenue, Hackensack, NJ · Hackensack Meridian Health · · NPI 1457456279
$6,966.64
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.
$10,303.00
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.
$588.47 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 | $588.47 | ↓ -92% |
| CLOVER | MEDICARE ADVANTAGE | $1,854.54 | ↓ -73% |
| AETNA | MANAGED MEDICAID | $2,586.05 | ↓ -63% |
| HORIZON | MANAGED MEDICAID | $2,728.00 | ↓ -61% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $2,946.66 | ↓ -58% |
| LHP HEALTH | ALL PRODUCTS | $3,548.00 | ↓ -49% |
| OPTUM HEALTH | MANAGED MEDICAID | $5,573.31 | ↓ -20% |
| HORIZON | OMNIA | $6,747.43 | ↓ -3% |
| AETNA | MEDICARE ADVANTAGE | $6,772.21 | ↓ -3% |
| OPTUM HEALTH | MEDICARE ADVANTAGE | $6,966.64 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $6,966.64 | ↑ +0% |
| HORIZON | MEDICARE ADVANTAGE | $6,966.64 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $6,966.64 | ↑ +0% |
| VACCN | ALL PRODUCTS | $6,966.64 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $6,966.64 | ↑ +0% |
| CHN | ALL PRODUCTS | $7,057.81 | ↑ +1% |
| INTERGROUP | ALL PRODUCTS | $7,212.10 | ↑ +4% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $7,314.97 | ↑ +5% |
| QUALCARE | HMO | $7,712.00 | ↑ +11% |
| HORIZON | PIP | $7,727.25 | ↑ +11% |
| BERGEN RISK | ALL PRODUCTS | $7,727.25 | ↑ +11% |
| AETNA | PPO | $7,773.00 | ↑ +12% |
| AETNA | ASA | $7,773.00 | ↑ +12% |
| AETNA | HMO | $7,773.00 | ↑ +12% |
| AMERIHEALTH | LOCAL HMO | $8,013.00 | ↑ +15% |
| CIGNA | BH | $8,242.40 | ↑ +18% |
| CIGNA | HMO | $8,357.00 | ↑ +20% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $8,539.00 | ↑ +23% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $8,757.55 | ↑ +26% |
| AMERIHEALTH | REGIONAL HMO | $8,904.00 | ↑ +28% |
| QUALCARE | WORKERS COMP | $9,169.67 | ↑ +32% |
| QUALCARE | PPO | $9,169.67 | ↑ +32% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,272.70 | ↑ +33% |
| CIGNA | PPO | $9,369.55 | ↑ +34% |
| OXFORD | ALL PRODUCTS | $9,571.00 | ↑ +37% |
| HORIZON | HMO | $9,812.58 | ↑ +41% |
| HORIZON | INDEMNITY | $9,863.06 | ↑ +42% |
| HORIZON | SHP | $9,925.91 | ↑ +42% |
| HORIZON | FEDERAL | $10,047.49 | ↑ +44% |
| HORIZON | PPO | $10,047.49 | ↑ +44% |
| UNITED HEALTHCARE | HMO | $11,528.00 | ↑ +65% |
| HORIZON | WORKERS COMP | $16,802.00 | ↑ +141% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Tonsillectomy (child under 12) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $6,547.81 | $1,634.42 – $8,562.79 |
| Ocean University Medical Center | Brick | $6,465.11 | $566.98 – $9,178.00 |