Fixation of knee joint at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$1,771.43
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.
$6,600.00
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.
$868.00 with HORIZON 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 |
|---|---|---|---|
| HORIZON | MANAGED MEDICAID | $868.00 | ↓ -51% |
| AETNA | MANAGED MEDICAID | $1,082.40 | ↓ -39% |
| CLOVER | MEDICARE ADVANTAGE | $1,188.00 | ↓ -33% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -33% |
| AETNA | MEDICARE ADVANTAGE | $1,194.60 | ↓ -33% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,234.20 | ↓ -30% |
| WELLCARE | MEDICARE ADVANTAGE | $1,771.43 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $1,771.43 | ↑ +0% |
| VACCN | ALL PRODUCTS | $1,771.43 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,771.43 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,860.00 | ↑ +5% |
| UNITED HEALTHCARE | DSNP | $2,125.72 | ↑ +20% |
| CIGNA | HMO | $2,247.00 | ↑ +27% |
| CIGNA | PPO | $2,518.00 | ↑ +42% |
| HORIZON | PIP | $4,257.00 | ↑ +140% |
| HORIZON | WORKERS COMP | $4,257.00 | ↑ +140% |
| HORIZON | OMNIA | $4,507.14 | ↑ +154% |
| BERGEN RISK | ALL PRODUCTS | $4,950.00 | ↑ +179% |
| QUALCARE | PPO | $5,128.20 | ↑ +189% |
| AETNA | ASA | $5,167.80 | ↑ +192% |
| CIGNA | BH | $5,280.00 | ↑ +198% |
| HORIZON | SHP | $5,511.66 | ↑ +211% |
| HORIZON | HMO | $5,565.78 | ↑ +214% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,610.00 | ↑ +217% |
| HORIZON | INDEMNITY | $5,645.64 | ↑ +219% |
| AMERIHEALTH | LOCAL HMO | $5,670.72 | ↑ +220% |
| HORIZON | PPO | $5,697.12 | ↑ +222% |
| QUALCARE | WORKERS COMP | $5,808.00 | ↑ +228% |
| OXFORD | ALL PRODUCTS | $6,096.00 | ↑ +244% |
| QUALCARE | HMO | $6,256.00 | ↑ +253% |
| AMERIHEALTH | REGIONAL HMO | $6,423.12 | ↑ +263% |
| UNITED HEALTHCARE | HMO | $7,527.00 | ↑ +325% |
| AETNA | PPO | $8,419.00 | ↑ +375% |
| AETNA | HMO | $8,419.00 | ↑ +375% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +461% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Fixation of knee joint at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $1,884.74 | $339.39 – $1,978.98 |
| Ocean University Medical Center | Brick | $1,749.06 | $326.92 – $2,718.61 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $1,772.97 | $127.38 – $2,718.61 |
| Jersey Shore University Medical Center | Neptune City | $1,771.43 | $326.92 – $2,125.72 |
| Palisades Medical Center | North Bergen | $1,884.74 | $125.47 – $2,054.37 |
| Raritan Bay Medical Center | Perth Amboy | $1,772.97 | $159.23 – $2,127.56 |
| Riverview Medical Center | Red Bank | $1,771.43 | $326.92 – $2,125.72 |
| Southern Ocean Medical Center | Manahawkin | $1,749.06 | $326.92 – $2,098.87 |