Ercp lesion ablate w/dilate 43278 at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$4,211.08
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.
$7,659.00
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.
$1,189.00 with UNITED HEALTHCARE 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 |
|---|---|---|---|
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -72% |
| AETNA | MANAGED MEDICAID | $1,256.08 | ↓ -70% |
| CLOVER | MEDICARE ADVANTAGE | $1,378.62 | ↓ -67% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,432.23 | ↓ -66% |
| HORIZON | MANAGED MEDICAID | $1,613.00 | ↓ -62% |
| VACCN | ALL PRODUCTS | $4,211.08 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,211.08 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $4,211.08 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $4,211.08 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,421.64 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $4,590.08 | ↑ +9% |
| HORIZON | PIP | $4,940.06 | ↑ +17% |
| HORIZON | WORKERS COMP | $4,940.06 | ↑ +17% |
| UNITED HEALTHCARE | DSNP | $5,053.30 | ↑ +20% |
| HORIZON | OMNIA | $5,230.33 | ↑ +24% |
| BERGEN RISK | ALL PRODUCTS | $5,744.25 | ↑ +36% |
| QUALCARE | PPO | $5,951.04 | ↑ +41% |
| AETNA | ASA | $5,997.00 | ↑ +42% |
| CIGNA | BH | $6,127.20 | ↑ +46% |
| QUALCARE | HMO | $6,256.00 | ↑ +49% |
| HORIZON | SHP | $6,396.03 | ↑ +52% |
| HORIZON | HMO | $6,458.83 | ↑ +53% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $6,510.15 | ↑ +55% |
| HORIZON | INDEMNITY | $6,551.51 | ↑ +56% |
| AMERIHEALTH | LOCAL HMO | $6,580.61 | ↑ +56% |
| HORIZON | PPO | $6,611.25 | ↑ +57% |
| QUALCARE | WORKERS COMP | $6,739.92 | ↑ +60% |
| CIGNA | HMO | $6,884.68 | ↑ +63% |
| CIGNA | PPO | $6,884.68 | ↑ +63% |
| AMERIHEALTH | REGIONAL HMO | $7,453.74 | ↑ +77% |
| OXFORD | ALL PRODUCTS | $8,143.00 | ↑ +93% |
| AETNA | HMO | $8,419.00 | ↑ +100% |
| AETNA | PPO | $8,419.00 | ↑ +100% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +136% |
| UNITED HEALTHCARE | HMO | $10,105.00 | ↑ +140% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Ercp lesion ablate w/dilate 43278 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $4,480.44 | $899.06 – $4,704.46 |
| Ocean University Medical Center | Brick | $4,157.89 | $873.63 – $4,989.47 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $4,214.73 | $397.92 – $4,214.73 |
| Jersey Shore University Medical Center | Neptune City | $4,211.08 | $873.63 – $5,053.30 |
| Palisades Medical Center | North Bergen | $4,480.44 | $391.95 – $4,883.68 |
| Raritan Bay Medical Center | Perth Amboy | $4,214.73 | $899.06 – $5,057.68 |
| Riverview Medical Center | Red Bank | $4,211.08 | $873.63 – $5,053.30 |
| Southern Ocean Medical Center | Manahawkin | $4,157.89 | $873.63 – $4,989.47 |