Clearance of tear duct at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$330.87
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.
$5,651.00
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.
$0.01 with CIGNA vs $9,933.00 with BRIGHTON HEALTH PLAN — 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 |
|---|---|---|---|
| CIGNA | PPO | $0.01 | ↓ -100% |
| CIGNA | HMO | $0.01 | ↓ -100% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $330.87 | ↑ +0% |
| VACCN | ALL PRODUCTS | $330.87 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $330.87 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $330.87 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $347.42 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $360.65 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $397.05 | ↑ +20% |
| AETNA | MANAGED MEDICAID | $926.76 | ↑ +180% |
| CLOVER | MEDICARE ADVANTAGE | $1,017.18 | ↑ +207% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,056.74 | ↑ +219% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↑ +259% |
| HORIZON | MANAGED MEDICAID | $1,613.00 | ↑ +388% |
| OXFORD | ALL PRODUCTS | $2,768.00 | ↑ +737% |
| UNITED HEALTHCARE | HMO | $3,336.00 | ↑ +908% |
| HORIZON | PIP | $3,644.90 | ↑ +1002% |
| HORIZON | WORKERS COMP | $3,644.90 | ↑ +1002% |
| HORIZON | OMNIA | $3,859.07 | ↑ +1066% |
| BERGEN RISK | ALL PRODUCTS | $4,238.25 | ↑ +1181% |
| QUALCARE | PPO | $4,390.83 | ↑ +1227% |
| AETNA | ASA | $4,424.73 | ↑ +1237% |
| CIGNA | BH | $4,520.80 | ↑ +1266% |
| HORIZON | SHP | $4,719.15 | ↑ +1326% |
| HORIZON | HMO | $4,765.49 | ↑ +1340% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,803.35 | ↑ +1352% |
| HORIZON | INDEMNITY | $4,833.87 | ↑ +1361% |
| AMERIHEALTH | LOCAL HMO | $4,855.34 | ↑ +1367% |
| HORIZON | PPO | $4,877.94 | ↑ +1374% |
| QUALCARE | WORKERS COMP | $4,972.88 | ↑ +1403% |
| AMERIHEALTH | REGIONAL HMO | $5,499.55 | ↑ +1562% |
| QUALCARE | HMO | $6,256.00 | ↑ +1791% |
| AETNA | HMO | $8,419.00 | ↑ +2445% |
| AETNA | PPO | $8,419.00 | ↑ +2445% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +2902% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Clearance of tear duct at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $352.04 | $281.63 – $540.59 |
| Ocean University Medical Center | Brick | $326.69 | $298.93 – $521.03 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $331.16 | $145.20 – $540.59 |
| Jersey Shore University Medical Center | Neptune City | $330.87 | $330.87 – $521.03 |
| Palisades Medical Center | North Bergen | $352.04 | $352.04 – $540.59 |
| Raritan Bay Medical Center | Perth Amboy | $331.16 | $331.16 – $540.59 |
| Riverview Medical Center | Red Bank | $330.87 | $330.87 – $521.03 |
| Southern Ocean Medical Center | Manahawkin | $326.69 | $326.69 – $521.03 |