Removal of adenoids at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$3,589.62
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.
$6,263.00
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.
$1,027.13 with AETNA vs $10,105.00 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 |
|---|---|---|---|
| AETNA | MANAGED MEDICAID | $1,027.13 | ↓ -71% |
| CLOVER | MEDICARE ADVANTAGE | $1,127.34 | ↓ -69% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,171.18 | ↓ -67% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -67% |
| HORIZON | MANAGED MEDICAID | $1,613.00 | ↓ -55% |
| VACCN | ALL PRODUCTS | $3,589.62 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,589.62 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,589.62 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,589.62 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,769.11 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $3,912.69 | ↑ +9% |
| HORIZON | PIP | $4,039.64 | ↑ +13% |
| HORIZON | WORKERS COMP | $4,039.64 | ↑ +13% |
| HORIZON | OMNIA | $4,277.00 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $4,307.55 | ↑ +20% |
| CIGNA | HMO | $4,412.00 | ↑ +23% |
| BERGEN RISK | ALL PRODUCTS | $4,697.25 | ↑ +31% |
| QUALCARE | PPO | $4,866.35 | ↑ +36% |
| AETNA | ASA | $4,903.93 | ↑ +37% |
| CIGNA | PPO | $4,943.00 | ↑ +38% |
| CIGNA | BH | $5,010.40 | ↑ +40% |
| HORIZON | SHP | $5,230.23 | ↑ +46% |
| HORIZON | HMO | $5,281.59 | ↑ +47% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,323.55 | ↑ +48% |
| HORIZON | INDEMNITY | $5,357.37 | ↑ +49% |
| AMERIHEALTH | LOCAL HMO | $5,381.17 | ↑ +50% |
| HORIZON | PPO | $5,406.22 | ↑ +51% |
| QUALCARE | WORKERS COMP | $5,511.44 | ↑ +54% |
| AMERIHEALTH | REGIONAL HMO | $6,095.15 | ↑ +70% |
| QUALCARE | HMO | $6,256.00 | ↑ +74% |
| OXFORD | ALL PRODUCTS | $8,143.00 | ↑ +127% |
| AETNA | HMO | $8,419.00 | ↑ +135% |
| AETNA | PPO | $8,419.00 | ↑ +135% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +177% |
| UNITED HEALTHCARE | HMO | $10,105.00 | ↑ +182% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Removal of adenoids at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $127.49 – $7,088.58 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $110.47 – $7,276.94 |
| Community Medical Center | Toms River | $3,786.00 | $113.14 – $7,053.14 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $109.14 – $7,240.56 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $131.24 – $7,276.94 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $119.79 – $7,600.27 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $218.28 – $7,143.34 |
| Hackensack University Medical Center | Hackensack | $3,819.23 | $537.58 – $4,010.20 |