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Established Patient Office Visit (level 1) at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
not published by hospital
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.
$275.00
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.
$26.89 with AETNA vs $267.63 with AMERIHEALTH — 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 | $26.89 | — |
| CLOVER | MEDICARE ADVANTAGE | $49.50 | — |
| AETNA | MEDICARE ADVANTAGE | $49.78 | — |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $51.43 | — |
| UNITED HEALTHCARE | MANAGED MEDICAID | $111.00 | — |
| UNITED HEALTHCARE | HMO | $155.90 | — |
| HORIZON | MANAGED MEDICAID | $167.45 | — |
| HORIZON | PIP | $177.38 | — |
| HORIZON | WORKERS COMP | $177.38 | — |
| OXFORD | ALL PRODUCTS | $180.15 | — |
| HORIZON | OMNIA | $187.80 | — |
| BERGEN RISK | ALL PRODUCTS | $206.25 | — |
| QUALCARE | HMO | $213.68 | — |
| QUALCARE | PPO | $213.68 | — |
| AETNA | ASA | $215.33 | — |
| CIGNA | BH | $220.00 | — |
| HORIZON | SHP | $229.65 | — |
| HORIZON | HMO | $231.91 | — |
| MULTIPLAN - PHCS | ALL PRODUCTS | $233.75 | — |
| HORIZON | INDEMNITY | $235.24 | — |
| AMERIHEALTH | LOCAL HMO | $236.28 | — |
| HORIZON | PPO | $237.38 | — |
| QUALCARE | WORKERS COMP | $242.00 | — |
| AETNA | PPO | $247.50 | — |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $247.50 | — |
| AETNA | HMO | $247.50 | — |
| AMERIHEALTH | REGIONAL HMO | $267.63 | — |
| WELLCARE | MANAGED MEDICAID | not published by hospital | — |
| VACCN | ALL PRODUCTS | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| WELLCARE | MEDICARE ADVANTAGE | not published by hospital | — |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | not published by hospital | — |
| UNITED HEALTHCARE | DSNP | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| CIGNA | HMO | not published by hospital | — |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | not published by hospital | — |
| CIGNA | PPO | not published by hospital | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 1) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | not published | $14.72 – $247.50 |
| Ocean University Medical Center | Brick | not published | $14.29 – $247.50 |