Bx of breast open 19101 at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$4,238.48
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.
$6,657.00
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.
$1,091.75 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 | $1,091.75 | ↓ -74% |
| HORIZON | MANAGED MEDICAID | $1,141.00 | ↓ -73% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -72% |
| CLOVER | MEDICARE ADVANTAGE | $1,198.26 | ↓ -72% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,244.86 | ↓ -71% |
| CIGNA | HMO | $3,135.00 | ↓ -26% |
| CIGNA | PPO | $3,508.00 | ↓ -17% |
| VACCN | ALL PRODUCTS | $4,238.48 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $4,238.48 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,238.48 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $4,238.48 | ↑ +0% |
| HORIZON | PIP | $4,293.77 | ↑ +1% |
| HORIZON | WORKERS COMP | $4,293.77 | ↑ +1% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,450.40 | ↑ +5% |
| HORIZON | OMNIA | $4,546.07 | ↑ +7% |
| AETNA | MEDICARE ADVANTAGE | $4,619.94 | ↑ +9% |
| BERGEN RISK | ALL PRODUCTS | $4,992.75 | ↑ +18% |
| UNITED HEALTHCARE | DSNP | $5,086.17 | ↑ +20% |
| QUALCARE | PPO | $5,172.49 | ↑ +22% |
| AETNA | ASA | $5,212.43 | ↑ +23% |
| CIGNA | BH | $5,325.60 | ↑ +26% |
| HORIZON | SHP | $5,559.26 | ↑ +31% |
| HORIZON | HMO | $5,613.85 | ↑ +32% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,658.45 | ↑ +34% |
| HORIZON | INDEMNITY | $5,694.40 | ↑ +34% |
| AMERIHEALTH | LOCAL HMO | $5,719.69 | ↑ +35% |
| HORIZON | PPO | $5,746.32 | ↑ +36% |
| QUALCARE | WORKERS COMP | $5,858.16 | ↑ +38% |
| QUALCARE | HMO | $6,256.00 | ↑ +48% |
| AMERIHEALTH | REGIONAL HMO | $6,478.59 | ↑ +53% |
| OXFORD | ALL PRODUCTS | $8,143.00 | ↑ +92% |
| AETNA | PPO | $8,419.00 | ↑ +99% |
| AETNA | HMO | $8,419.00 | ↑ +99% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +134% |
| UNITED HEALTHCARE | HMO | $10,105.00 | ↑ +138% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Bx of breast open 19101 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $4,509.59 | $479.73 – $4,735.07 |
| Ocean University Medical Center | Brick | $4,184.94 | $465.46 – $5,021.93 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $4,242.15 | $256.20 – $4,242.15 |
| Jersey Shore University Medical Center | Neptune City | $4,238.48 | $465.46 – $5,086.17 |
| Palisades Medical Center | North Bergen | $4,509.59 | $479.73 – $4,915.45 |
| Raritan Bay Medical Center | Perth Amboy | $4,242.15 | $479.73 – $5,090.58 |
| Riverview Medical Center | Red Bank | $4,238.48 | $465.46 – $5,086.17 |
| Southern Ocean Medical Center | Manahawkin | $4,184.94 | $465.46 – $5,021.93 |