healthcosts.net
Tonsillectomy (age 12+) 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.
$5,580.00
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.
$915.12 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 | $915.12 | ↓ -75% |
| CLOVER | MEDICARE ADVANTAGE | $1,004.40 | ↓ -72% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,043.46 | ↓ -71% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -67% |
| HORIZON | MANAGED MEDICAID | $1,613.00 | ↓ -55% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,589.62 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,589.62 | ↑ +0% |
| VACCN | ALL PRODUCTS | $3,589.62 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,589.62 | ↑ +0% |
| HORIZON | PIP | $3,599.10 | ↑ +0% |
| HORIZON | WORKERS COMP | $3,599.10 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,769.11 | ↑ +5% |
| HORIZON | OMNIA | $3,810.58 | ↑ +6% |
| AETNA | MEDICARE ADVANTAGE | $3,912.69 | ↑ +9% |
| BERGEN RISK | ALL PRODUCTS | $4,185.00 | ↑ +17% |
| UNITED HEALTHCARE | DSNP | $4,307.55 | ↑ +20% |
| QUALCARE | PPO | $4,335.66 | ↑ +21% |
| AETNA | ASA | $4,369.14 | ↑ +22% |
| CIGNA | HMO | $4,412.00 | ↑ +23% |
| CIGNA | BH | $4,464.00 | ↑ +24% |
| HORIZON | SHP | $4,659.86 | ↑ +30% |
| HORIZON | HMO | $4,705.61 | ↑ +31% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,743.00 | ↑ +32% |
| HORIZON | INDEMNITY | $4,773.13 | ↑ +33% |
| AMERIHEALTH | LOCAL HMO | $4,794.34 | ↑ +34% |
| HORIZON | PPO | $4,816.66 | ↑ +34% |
| QUALCARE | WORKERS COMP | $4,910.40 | ↑ +37% |
| CIGNA | PPO | $4,943.00 | ↑ +38% |
| AMERIHEALTH | REGIONAL HMO | $5,430.46 | ↑ +51% |
| QUALCARE | HMO | $6,256.00 | ↑ +74% |
| OXFORD | ALL PRODUCTS | $8,143.00 | ↑ +127% |
| AETNA | PPO | $8,419.00 | ↑ +135% |
| AETNA | HMO | $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
Tonsillectomy (age 12+) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $3,819.23 | $559.42 – $6,467.40 |
| Ocean University Medical Center | Brick | $3,544.29 | $539.41 – $6,502.61 |