Sigmoidoscopy and biopsy at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$1,009.14
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.
$2,566.00
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.
$420.82 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 | $420.82 | ↓ -58% |
| CLOVER | MEDICARE ADVANTAGE | $461.88 | ↓ -54% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $479.84 | ↓ -52% |
| HORIZON | MANAGED MEDICAID | $868.00 | ↓ -14% |
| WELLCARE | MEDICARE ADVANTAGE | $1,009.14 | ↑ +0% |
| VACCN | ALL PRODUCTS | $1,009.14 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $1,009.14 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,009.14 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,059.59 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $1,099.96 | ↑ +9% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↑ +18% |
| UNITED HEALTHCARE | DSNP | $1,210.96 | ↑ +20% |
| HORIZON | WORKERS COMP | $1,655.07 | ↑ +64% |
| HORIZON | PIP | $1,655.07 | ↑ +64% |
| HORIZON | OMNIA | $1,752.32 | ↑ +74% |
| BERGEN RISK | ALL PRODUCTS | $1,924.50 | ↑ +91% |
| QUALCARE | PPO | $1,993.78 | ↑ +98% |
| AETNA | ASA | $2,009.18 | ↑ +99% |
| CIGNA | BH | $2,052.80 | ↑ +103% |
| HORIZON | SHP | $2,142.87 | ↑ +112% |
| HORIZON | HMO | $2,163.91 | ↑ +114% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $2,181.10 | ↑ +116% |
| HORIZON | INDEMNITY | $2,194.96 | ↑ +118% |
| AMERIHEALTH | LOCAL HMO | $2,204.71 | ↑ +118% |
| HORIZON | PPO | $2,214.97 | ↑ +119% |
| CIGNA | HMO | $2,247.00 | ↑ +123% |
| QUALCARE | WORKERS COMP | $2,258.08 | ↑ +124% |
| AMERIHEALTH | REGIONAL HMO | $2,497.23 | ↑ +147% |
| CIGNA | PPO | $2,518.00 | ↑ +150% |
| OXFORD | ALL PRODUCTS | $4,048.00 | ↑ +301% |
| UNITED HEALTHCARE | HMO | $4,948.00 | ↑ +390% |
| QUALCARE | HMO | $6,256.00 | ↑ +520% |
| AETNA | HMO | $8,419.00 | ↑ +734% |
| AETNA | PPO | $8,419.00 | ↑ +734% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +884% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Sigmoidoscopy and biopsy at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $149.30 – $1,992.78 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $89.64 – $2,045.74 |
| Community Medical Center | Toms River | $3,786.00 | $91.80 – $1,982.82 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $88.56 – $2,035.51 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $153.69 – $2,045.74 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $97.20 – $2,136.62 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $177.12 – $2,008.19 |
| Hackensack University Medical Center | Hackensack | $1,073.68 | $153.19 – $1,127.37 |