Ercp bil/panc duct; each stent plcmt 43274 at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$6,588.93
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.
$7,040.00
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.
$1,154.56 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 | $1,154.56 | ↓ -82% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -82% |
| CLOVER | MEDICARE ADVANTAGE | $1,267.20 | ↓ -81% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,316.48 | ↓ -80% |
| HORIZON | MANAGED MEDICAID | $1,613.00 | ↓ -76% |
| HORIZON | WORKERS COMP | $4,540.80 | ↓ -31% |
| HORIZON | PIP | $4,540.80 | ↓ -31% |
| HORIZON | OMNIA | $4,807.62 | ↓ -27% |
| BERGEN RISK | ALL PRODUCTS | $5,280.00 | ↓ -20% |
| QUALCARE | PPO | $5,470.08 | ↓ -17% |
| AETNA | ASA | $5,512.32 | ↓ -16% |
| CIGNA | BH | $5,632.00 | ↓ -15% |
| HORIZON | SHP | $5,879.10 | ↓ -11% |
| HORIZON | HMO | $5,936.83 | ↓ -10% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,984.00 | ↓ -9% |
| HORIZON | INDEMNITY | $6,022.02 | ↓ -9% |
| AMERIHEALTH | LOCAL HMO | $6,048.77 | ↓ -8% |
| HORIZON | PPO | $6,076.93 | ↓ -8% |
| QUALCARE | WORKERS COMP | $6,195.20 | ↓ -6% |
| QUALCARE | HMO | $6,256.00 | ↓ -5% |
| CIGNA | HMO | $6,328.26 | ↓ -4% |
| CIGNA | PPO | $6,328.26 | ↓ -4% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $6,588.93 | ↑ +0% |
| VACCN | ALL PRODUCTS | $6,588.93 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $6,588.93 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $6,588.93 | ↑ +0% |
| AMERIHEALTH | REGIONAL HMO | $6,851.33 | ↑ +4% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $6,918.37 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $7,181.93 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $7,906.71 | ↑ +20% |
| OXFORD | ALL PRODUCTS | $8,143.00 | ↑ +24% |
| AETNA | PPO | $8,419.00 | ↑ +28% |
| AETNA | HMO | $8,419.00 | ↑ +28% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +51% |
| UNITED HEALTHCARE | HMO | $10,105.00 | ↑ +53% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Ercp bil/panc duct; each stent plcmt 43274 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $7,010.39 | $960.28 – $7,360.91 |
| Ocean University Medical Center | Brick | $6,505.71 | $933.19 – $7,806.85 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $6,594.64 | $421.84 – $6,594.64 |
| Jersey Shore University Medical Center | Neptune City | $6,588.93 | $933.19 – $7,906.71 |
| Palisades Medical Center | North Bergen | $7,010.39 | $415.51 – $7,641.32 |
| Raritan Bay Medical Center | Perth Amboy | $6,594.64 | $960.28 – $7,913.57 |
| Riverview Medical Center | Red Bank | $6,588.93 | $933.19 – $7,906.71 |
| Southern Ocean Medical Center | Manahawkin | $6,505.71 | $933.19 – $7,806.85 |