Capsulotomy; interphalangeal joint, each joint (separate proc) at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$1,771.43
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.
?
What you pay up front if you don't use insurance.
$3,607.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$591.55 with AETNA vs $10,105.00 with UNITED HEALTHCARE — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $591.55 | ↓ -67% |
| CLOVER | MEDICARE ADVANTAGE | $649.26 | ↓ -63% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $674.51 | ↓ -62% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -33% |
| HORIZON | MANAGED MEDICAID | $1,613.00 | ↓ -9% |
| VACCN | ALL PRODUCTS | $1,771.43 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $1,771.43 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $1,771.43 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,771.43 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,860.00 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $1,930.86 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $2,125.72 | ↑ +20% |
| HORIZON | PIP | $2,326.52 | ↑ +31% |
| HORIZON | WORKERS COMP | $2,326.52 | ↑ +31% |
| HORIZON | OMNIA | $2,463.22 | ↑ +39% |
| BERGEN RISK | ALL PRODUCTS | $2,705.25 | ↑ +53% |
| QUALCARE | PPO | $2,802.64 | ↑ +58% |
| AETNA | ASA | $2,824.28 | ↑ +59% |
| CIGNA | BH | $2,885.60 | ↑ +63% |
| HORIZON | SHP | $3,012.21 | ↑ +70% |
| HORIZON | HMO | $3,041.78 | ↑ +72% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $3,065.95 | ↑ +73% |
| HORIZON | INDEMNITY | $3,085.43 | ↑ +74% |
| AMERIHEALTH | LOCAL HMO | $3,099.13 | ↑ +75% |
| HORIZON | PPO | $3,113.56 | ↑ +76% |
| QUALCARE | WORKERS COMP | $3,174.16 | ↑ +79% |
| CIGNA | PPO | $3,242.33 | ↑ +83% |
| CIGNA | HMO | $3,242.33 | ↑ +83% |
| AMERIHEALTH | REGIONAL HMO | $3,510.33 | ↑ +98% |
| QUALCARE | HMO | $6,256.00 | ↑ +253% |
| OXFORD | ALL PRODUCTS | $8,143.00 | ↑ +360% |
| AETNA | HMO | $8,419.00 | ↑ +375% |
| AETNA | PPO | $8,419.00 | ↑ +375% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +461% |
| UNITED HEALTHCARE | HMO | $10,105.00 | ↑ +470% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Capsulotomy; interphalangeal joint, each joint (separate proc) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $1,884.74 | $544.92 – $1,978.98 |
| Ocean University Medical Center | Brick | $1,749.06 | $525.78 – $2,098.87 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $1,772.97 | $95.70 – $1,772.97 |
| Jersey Shore University Medical Center | Neptune City | $1,771.43 | $525.78 – $2,125.72 |
| Palisades Medical Center | North Bergen | $1,884.74 | $544.92 – $2,054.37 |
| Raritan Bay Medical Center | Perth Amboy | $1,772.97 | $544.92 – $2,127.56 |
| Riverview Medical Center | Red Bank | $1,771.43 | $525.78 – $2,125.72 |
| Southern Ocean Medical Center | Manahawkin | $1,749.06 | $525.78 – $2,098.87 |