Biopsy of tear sac at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$2,582.26
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.
$2,906.00
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.
$476.58 with AETNA vs $10,105.00 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 |
|---|---|---|---|
| AETNA | MANAGED MEDICAID | $476.58 | ↓ -82% |
| CLOVER | MEDICARE ADVANTAGE | $523.08 | ↓ -80% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $543.42 | ↓ -79% |
| HORIZON | MANAGED MEDICAID | $868.00 | ↓ -66% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -54% |
| HORIZON | WORKERS COMP | $1,874.37 | ↓ -27% |
| HORIZON | PIP | $1,874.37 | ↓ -27% |
| HORIZON | OMNIA | $1,984.51 | ↓ -23% |
| BERGEN RISK | ALL PRODUCTS | $2,179.50 | ↓ -16% |
| CIGNA | HMO | $2,247.00 | ↓ -13% |
| QUALCARE | PPO | $2,257.96 | ↓ -13% |
| AETNA | ASA | $2,275.40 | ↓ -12% |
| CIGNA | BH | $2,324.80 | ↓ -10% |
| HORIZON | SHP | $2,426.80 | ↓ -6% |
| HORIZON | HMO | $2,450.63 | ↓ -5% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $2,470.10 | ↓ -4% |
| HORIZON | INDEMNITY | $2,485.79 | ↓ -4% |
| AMERIHEALTH | LOCAL HMO | $2,496.84 | ↓ -3% |
| HORIZON | PPO | $2,508.46 | ↓ -3% |
| CIGNA | PPO | $2,518.00 | ↓ -2% |
| QUALCARE | WORKERS COMP | $2,557.28 | ↓ -1% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $2,582.26 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $2,582.26 | ↑ +0% |
| VACCN | ALL PRODUCTS | $2,582.26 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $2,582.26 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $2,711.37 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $2,814.66 | ↑ +9% |
| AMERIHEALTH | REGIONAL HMO | $2,828.12 | ↑ +10% |
| UNITED HEALTHCARE | DSNP | $3,098.71 | ↑ +20% |
| QUALCARE | HMO | $6,256.00 | ↑ +142% |
| OXFORD | ALL PRODUCTS | $8,143.00 | ↑ +215% |
| AETNA | HMO | $8,419.00 | ↑ +226% |
| AETNA | PPO | $8,419.00 | ↑ +226% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +285% |
| UNITED HEALTHCARE | HMO | $10,105.00 | ↑ +291% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of tear sac at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $2,747.43 | $539.96 – $2,884.81 |
| Ocean University Medical Center | Brick | $2,549.65 | $522.81 – $3,059.57 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $2,584.50 | $72.60 – $2,584.50 |
| Jersey Shore University Medical Center | Neptune City | $2,582.26 | $522.81 – $3,098.71 |
| Palisades Medical Center | North Bergen | $2,747.43 | $539.96 – $2,994.70 |
| Raritan Bay Medical Center | Perth Amboy | $2,584.50 | $539.96 – $3,101.40 |
| Riverview Medical Center | Red Bank | $2,582.26 | $522.81 – $3,098.71 |
| Southern Ocean Medical Center | Manahawkin | $2,549.65 | $522.81 – $3,059.57 |