Partial removal of fibula at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$3,591.33
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.
$9,280.00
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.
$1,141.00 with HORIZON vs $13,844.00 with UNITED HEALTHCARE — 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 | $1,141.00 | ↓ -68% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -67% |
| AETNA | MANAGED MEDICAID | $1,521.92 | ↓ -58% |
| CLOVER | MEDICARE ADVANTAGE | $1,670.40 | ↓ -53% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,735.36 | ↓ -52% |
| CIGNA | HMO | $3,135.00 | ↓ -13% |
| CIGNA | PPO | $3,508.00 | ↓ -2% |
| WELLCARE | MEDICARE ADVANTAGE | $3,591.33 | ↑ +0% |
| VACCN | ALL PRODUCTS | $3,591.33 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,591.33 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,591.33 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,770.90 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $3,914.55 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $4,309.59 | ↑ +20% |
| HORIZON | PIP | $5,985.60 | ↑ +67% |
| HORIZON | WORKERS COMP | $5,985.60 | ↑ +67% |
| QUALCARE | HMO | $6,256.00 | ↑ +74% |
| HORIZON | OMNIA | $6,337.31 | ↑ +76% |
| BERGEN RISK | ALL PRODUCTS | $6,960.00 | ↑ +94% |
| QUALCARE | PPO | $7,210.56 | ↑ +101% |
| AETNA | ASA | $7,266.24 | ↑ +102% |
| CIGNA | BH | $7,424.00 | ↑ +107% |
| HORIZON | SHP | $7,749.73 | ↑ +116% |
| HORIZON | HMO | $7,825.82 | ↑ +118% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $7,888.00 | ↑ +120% |
| HORIZON | INDEMNITY | $7,938.11 | ↑ +121% |
| AMERIHEALTH | LOCAL HMO | $7,973.38 | ↑ +122% |
| HORIZON | PPO | $8,010.50 | ↑ +123% |
| QUALCARE | WORKERS COMP | $8,166.40 | ↑ +127% |
| AETNA | PPO | $8,419.00 | ↑ +134% |
| AETNA | HMO | $8,419.00 | ↑ +134% |
| AMERIHEALTH | REGIONAL HMO | $9,031.30 | ↑ +151% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +177% |
| OXFORD | ALL PRODUCTS | $11,114.00 | ↑ +209% |
| UNITED HEALTHCARE | HMO | $13,844.00 | ↑ +285% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Partial removal of fibula at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $335.79 – $7,091.94 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $525.77 – $7,280.38 |
| Community Medical Center | Toms River | $3,786.00 | $538.44 – $7,056.48 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $519.44 – $7,243.98 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $345.67 – $7,280.38 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $434.56 – $7,603.89 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $1,038.87 – $7,146.75 |
| Hackensack University Medical Center | Hackensack | $3,821.05 | $1,410.44 – $4,012.10 |