Close tear system fistula 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.
$6,105.00
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.
$1,001.22 with AETNA 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 |
|---|---|---|---|
| AETNA | MANAGED MEDICAID | $1,001.22 | ↓ -61% |
| CLOVER | MEDICARE ADVANTAGE | $1,098.90 | ↓ -57% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,141.64 | ↓ -56% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -54% |
| HORIZON | MANAGED MEDICAID | $1,613.00 | ↓ -38% |
| VACCN | ALL PRODUCTS | $2,582.26 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $2,582.26 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $2,582.26 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $2,582.26 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $2,711.37 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $2,814.66 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $3,098.71 | ↑ +20% |
| HORIZON | PIP | $3,937.73 | ↑ +52% |
| HORIZON | WORKERS COMP | $3,937.73 | ↑ +52% |
| OXFORD | ALL PRODUCTS | $4,048.00 | ↑ +57% |
| HORIZON | OMNIA | $4,169.10 | ↑ +61% |
| CIGNA | HMO | $4,412.00 | ↑ +71% |
| BERGEN RISK | ALL PRODUCTS | $4,578.75 | ↑ +77% |
| QUALCARE | PPO | $4,743.59 | ↑ +84% |
| AETNA | ASA | $4,780.22 | ↑ +85% |
| CIGNA | BH | $4,884.00 | ↑ +89% |
| CIGNA | PPO | $4,943.00 | ↑ +91% |
| UNITED HEALTHCARE | HMO | $4,948.00 | ↑ +92% |
| HORIZON | SHP | $5,098.29 | ↑ +97% |
| HORIZON | HMO | $5,148.35 | ↑ +99% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,189.25 | ↑ +101% |
| HORIZON | INDEMNITY | $5,222.22 | ↑ +102% |
| AMERIHEALTH | LOCAL HMO | $5,245.42 | ↑ +103% |
| HORIZON | PPO | $5,269.84 | ↑ +104% |
| QUALCARE | WORKERS COMP | $5,372.40 | ↑ +108% |
| AMERIHEALTH | REGIONAL HMO | $5,941.39 | ↑ +130% |
| QUALCARE | HMO | $6,256.00 | ↑ +142% |
| AETNA | HMO | $8,419.00 | ↑ +226% |
| AETNA | PPO | $8,419.00 | ↑ +226% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +285% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Close tear system fistula at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $2,747.43 | $1,342.90 – $2,884.81 |
| Ocean University Medical Center | Brick | $2,549.65 | $1,291.47 – $3,059.57 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $2,584.50 | $275.88 – $2,584.50 |
| Jersey Shore University Medical Center | Neptune City | $2,582.26 | $1,291.47 – $3,098.71 |
| Palisades Medical Center | North Bergen | $2,747.43 | $1,342.90 – $2,994.70 |
| Raritan Bay Medical Center | Perth Amboy | $2,584.50 | $1,342.90 – $3,101.40 |
| Riverview Medical Center | Red Bank | $2,582.26 | $1,291.47 – $3,098.71 |
| Southern Ocean Medical Center | Manahawkin | $2,549.65 | $1,291.47 – $3,059.57 |