Pt re-evaluation patient/family at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$86.04
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.
$286.00
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.
$51.48 with CLOVER vs $447.00 with OXFORD — 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 | $51.48 | ↓ -40% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $53.48 | ↓ -38% |
| HORIZON | MANAGED MEDICAID | $60.00 | ↓ -30% |
| AETNA | MANAGED MEDICAID | $86.04 | ↑ +0% |
| AMERIGROUP | MANAGED MEDICAID | $86.04 | ↑ +0% |
| VACCN | ALL PRODUCTS | $86.04 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $90.34 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $93.78 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $103.25 | ↑ +20% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $168.45 | ↑ +96% |
| HORIZON | WORKERS COMP | $184.47 | ↑ +114% |
| HORIZON | PIP | $184.47 | ↑ +114% |
| HORIZON | OMNIA | $195.31 | ↑ +127% |
| AETNA | PPO | $208.01 | ↑ +142% |
| AETNA | HMO | $208.01 | ↑ +142% |
| QUALCARE | PPO | $222.22 | ↑ +158% |
| AETNA | ASA | $223.94 | ↑ +160% |
| WELLCARE | MEDICARE ADVANTAGE | $224.00 | ↑ +160% |
| WELLCARE | MANAGED MEDICAID | $224.00 | ↑ +160% |
| CIGNA | BH | $228.80 | ↑ +166% |
| HORIZON | SHP | $238.84 | ↑ +178% |
| HORIZON | HMO | $241.18 | ↑ +180% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $243.10 | ↑ +183% |
| HORIZON | INDEMNITY | $244.64 | ↑ +184% |
| AMERIHEALTH | LOCAL HMO | $245.73 | ↑ +186% |
| HORIZON | PPO | $246.88 | ↑ +187% |
| CIGNA | PPO | $273.50 | ↑ +218% |
| CIGNA | HMO | $273.50 | ↑ +218% |
| QUALCARE | WORKERS COMP | $278.00 | ↑ +223% |
| AMERIHEALTH | REGIONAL HMO | $278.34 | ↑ +224% |
| BERGEN RISK | ALL PRODUCTS | $291.00 | ↑ +238% |
| QUALCARE | HMO | $306.00 | ↑ +256% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $355.00 | ↑ +313% |
| UNITED HEALTHCARE | HMO | $359.00 | ↑ +317% |
| OXFORD | ALL PRODUCTS | $447.00 | ↑ +420% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Pt re-evaluation patient/family at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Saint Barnabas Behavioral Health Center | Toms River | $76.26 | not published |
| Childrens Specialized Hospital | Mountainside | $283.50 | $237.00 – $394.00 |
| Hackensack University Medical Center | Hackensack | $86.04 | $54.05 – $406.00 |
| Ocean University Medical Center | Brick | $86.04 | $60.00 – $500.00 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $86.04 | $60.00 – $523.00 |
| Jersey Shore University Medical Center | Neptune City | $86.04 | $68.83 – $561.00 |
| Palisades Medical Center | North Bergen | $86.04 | $86.04 – $558.00 |
| Raritan Bay Medical Center | Perth Amboy | $86.04 | $86.04 – $471.00 |