Surgical pathology level 5 gross & microscopic examination at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$398.16
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.
$1,100.00
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.
$180.40 with AETNA vs $1,070.52 with AMERIHEALTH — 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 | $180.40 | ↓ -55% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $180.98 | ↓ -55% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $205.70 | ↓ -48% |
| WELLCARE | MEDICARE ADVANTAGE | $398.16 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $398.16 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $398.16 | ↑ +0% |
| VACCN | ALL PRODUCTS | $398.16 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $418.07 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $433.99 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $477.79 | ↑ +20% |
| QUALCARE | HMO | $545.60 | ↑ +37% |
| OXFORD | ALL PRODUCTS | $597.81 | ↑ +50% |
| UNITED HEALTHCARE | HMO | $597.81 | ↑ +50% |
| HORIZON | MANAGED MEDICAID | $669.79 | ↑ +68% |
| HORIZON | WORKERS COMP | $709.50 | ↑ +78% |
| HORIZON | PIP | $709.50 | ↑ +78% |
| HORIZON | OMNIA | $751.19 | ↑ +89% |
| AETNA | HMO | $756.80 | ↑ +90% |
| AETNA | PPO | $756.80 | ↑ +90% |
| BERGEN RISK | ALL PRODUCTS | $825.00 | ↑ +107% |
| QUALCARE | PPO | $854.70 | ↑ +115% |
| AETNA | ASA | $861.30 | ↑ +116% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $880.00 | ↑ +121% |
| CIGNA | BH | $880.00 | ↑ +121% |
| HORIZON | SHP | $918.61 | ↑ +131% |
| HORIZON | HMO | $927.63 | ↑ +133% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $935.00 | ↑ +135% |
| HORIZON | INDEMNITY | $940.94 | ↑ +136% |
| AMERIHEALTH | LOCAL HMO | $945.12 | ↑ +137% |
| HORIZON | PPO | $949.52 | ↑ +138% |
| QUALCARE | WORKERS COMP | $968.00 | ↑ +143% |
| CIGNA | PPO | $1,051.93 | ↑ +164% |
| CIGNA | HMO | $1,051.93 | ↑ +164% |
| AMERIHEALTH | REGIONAL HMO | $1,070.52 | ↑ +169% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| CLOVER | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $287.18 | $152.33 – $836.55 |
| Cooperman Barnabas Medical Center | Livingston | $274.41 | $96.76 – $836.55 |
| Community Medical Center | Toms River | $317.32 | $96.76 – $836.55 |
| Clara Maass Medical Center | Belleville | $221.77 | $96.76 – $836.55 |
| Newark Beth Israel Medical Center | Newark | $269.74 | $96.76 – $836.55 |
| Jersey City Medical Center | Jersey City | $317.93 | $96.76 – $843.02 |
| Monmouth Medical Center | Long Branch | $334.76 | $96.76 – $836.55 |
| Hackensack University Medical Center | Hackensack | $423.63 | $87.72 – $672.67 |