Incise/drain eyelid lining at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$1,072.04
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.
$5,698.00
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.
$934.47 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 | $934.47 | ↓ -13% |
| CLOVER | MEDICARE ADVANTAGE | $1,025.64 | ↓ -4% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,065.53 | ↓ -1% |
| WELLCARE | MANAGED MEDICAID | $1,072.04 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $1,072.04 | ↑ +0% |
| VACCN | ALL PRODUCTS | $1,072.04 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,072.04 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,125.64 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $1,168.52 | ↑ +9% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↑ +11% |
| UNITED HEALTHCARE | DSNP | $1,286.45 | ↑ +20% |
| HORIZON | MANAGED MEDICAID | $1,613.00 | ↑ +50% |
| HORIZON | PIP | $3,675.21 | ↑ +243% |
| HORIZON | WORKERS COMP | $3,675.21 | ↑ +243% |
| HORIZON | OMNIA | $3,891.16 | ↑ +263% |
| BERGEN RISK | ALL PRODUCTS | $4,273.50 | ↑ +299% |
| QUALCARE | PPO | $4,427.35 | ↑ +313% |
| AETNA | ASA | $4,461.53 | ↑ +316% |
| CIGNA | BH | $4,558.40 | ↑ +325% |
| HORIZON | SHP | $4,758.40 | ↑ +344% |
| HORIZON | HMO | $4,805.12 | ↑ +348% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,843.30 | ↑ +352% |
| HORIZON | INDEMNITY | $4,874.07 | ↑ +355% |
| AMERIHEALTH | LOCAL HMO | $4,895.72 | ↑ +357% |
| HORIZON | PPO | $4,918.51 | ↑ +359% |
| QUALCARE | WORKERS COMP | $5,014.24 | ↑ +368% |
| CIGNA | PPO | $5,121.93 | ↑ +378% |
| CIGNA | HMO | $5,121.93 | ↑ +378% |
| AMERIHEALTH | REGIONAL HMO | $5,545.29 | ↑ +417% |
| OXFORD | ALL PRODUCTS | $6,096.00 | ↑ +469% |
| QUALCARE | HMO | $6,256.00 | ↑ +484% |
| UNITED HEALTHCARE | HMO | $7,527.00 | ↑ +602% |
| AETNA | PPO | $8,419.00 | ↑ +685% |
| AETNA | HMO | $8,419.00 | ↑ +685% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +827% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Incise/drain eyelid lining at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $1,140.61 | $237.09 – $1,197.64 |
| Ocean University Medical Center | Brick | $1,058.50 | $227.82 – $1,270.20 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $1,072.97 | $38.72 – $1,072.97 |
| Jersey Shore University Medical Center | Neptune City | $1,072.04 | $227.82 – $1,286.45 |
| Palisades Medical Center | North Bergen | $1,140.61 | $237.09 – $1,243.27 |
| Raritan Bay Medical Center | Perth Amboy | $1,072.97 | $237.09 – $1,287.56 |
| Riverview Medical Center | Red Bank | $1,072.04 | $227.82 – $1,286.45 |
| Southern Ocean Medical Center | Manahawkin | $1,058.50 | $227.82 – $1,270.20 |