Lead capillary at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$12.11
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.
$121.00
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.
$12.11 with CLOVER vs $55.49 with CIGNA — 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 |
|---|---|---|---|
| CLOVER | MEDICARE ADVANTAGE | $12.11 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $12.11 | ↑ +0% |
| AETNA | MANAGED MEDICAID | $12.11 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $12.11 | ↑ +0% |
| AMERIGROUP | MANAGED MEDICAID | $12.11 | ↑ +0% |
| VACCN | ALL PRODUCTS | $12.11 | ↑ +0% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $12.11 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $12.72 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $13.20 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $14.53 | ↑ +20% |
| QUALCARE | HMO | $14.88 | ↑ +23% |
| HORIZON | MANAGED MEDICAID | $18.27 | ↑ +51% |
| HORIZON | PIP | $19.35 | ↑ +60% |
| HORIZON | WORKERS COMP | $19.35 | ↑ +60% |
| HORIZON | OMNIA | $20.49 | ↑ +69% |
| AETNA | HMO | $20.64 | ↑ +70% |
| AETNA | PPO | $20.64 | ↑ +70% |
| BERGEN RISK | ALL PRODUCTS | $22.50 | ↑ +86% |
| QUALCARE | PPO | $23.31 | ↑ +92% |
| AETNA | ASA | $23.49 | ↑ +94% |
| CIGNA | BH | $24.00 | ↑ +98% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $24.00 | ↑ +98% |
| OXFORD | ALL PRODUCTS | $24.86 | ↑ +105% |
| UNITED HEALTHCARE | HMO | $24.86 | ↑ +105% |
| HORIZON | SHP | $25.05 | ↑ +107% |
| HORIZON | HMO | $25.30 | ↑ +109% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $25.50 | ↑ +111% |
| HORIZON | INDEMNITY | $25.66 | ↑ +112% |
| AMERIHEALTH | LOCAL HMO | $25.78 | ↑ +113% |
| HORIZON | PPO | $25.90 | ↑ +114% |
| QUALCARE | WORKERS COMP | $26.40 | ↑ +118% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $26.57 | ↑ +119% |
| AMERIHEALTH | REGIONAL HMO | $29.20 | ↑ +141% |
| CIGNA | HMO | $55.49 | ↑ +358% |
| CIGNA | PPO | $55.49 | ↑ +358% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Lead capillary at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Carrier Clinic | Belle Mead | $48.40 | $17.55 – $17.55 |
| Trinitas Regional Medical Center | Elizabeth | $13.32 | $5.69 – $57.52 |
| Cooperman Barnabas Medical Center | Livingston | $13.32 | $5.69 – $49.40 |
| Community Medical Center | Toms River | $13.32 | $5.69 – $49.40 |
| Clara Maass Medical Center | Belleville | $13.32 | $5.69 – $49.40 |
| Childrens Specialized Hospital | Mountainside | $37.00 | $9.69 – $9.98 |
| Newark Beth Israel Medical Center | Newark | $13.32 | $5.69 – $49.40 |
| Jersey City Medical Center | Jersey City | $13.32 | $5.69 – $49.40 |