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Tonsillectomy (child under 12) at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$6,547.81
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.
$9,966.00
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.
$1,189.00 with UNITED HEALTHCARE 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 |
|---|---|---|---|
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -82% |
| HORIZON | MANAGED MEDICAID | $1,613.00 | ↓ -75% |
| AETNA | MANAGED MEDICAID | $1,634.42 | ↓ -75% |
| CLOVER | MEDICARE ADVANTAGE | $1,793.88 | ↓ -73% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,863.64 | ↓ -72% |
| CIGNA | HMO | $4,412.00 | ↓ -33% |
| CIGNA | PPO | $4,943.00 | ↓ -25% |
| QUALCARE | HMO | $6,256.00 | ↓ -4% |
| HORIZON | PIP | $6,428.07 | ↓ -2% |
| HORIZON | WORKERS COMP | $6,428.07 | ↓ -2% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $6,547.81 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $6,547.81 | ↑ +0% |
| VACCN | ALL PRODUCTS | $6,547.81 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $6,547.81 | ↑ +0% |
| HORIZON | OMNIA | $6,805.78 | ↑ +4% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $6,875.20 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $7,137.11 | ↑ +9% |
| BERGEN RISK | ALL PRODUCTS | $7,474.50 | ↑ +14% |
| QUALCARE | PPO | $7,743.58 | ↑ +18% |
| AETNA | ASA | $7,803.38 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $7,857.37 | ↑ +20% |
| CIGNA | BH | $7,972.80 | ↑ +22% |
| HORIZON | SHP | $8,004.00 | ↑ +22% |
| OXFORD | ALL PRODUCTS | $8,143.00 | ↑ +24% |
| HORIZON | HMO | $8,404.33 | ↑ +28% |
| AETNA | PPO | $8,419.00 | ↑ +29% |
| AETNA | HMO | $8,419.00 | ↑ +29% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $8,471.10 | ↑ +29% |
| HORIZON | INDEMNITY | $8,524.92 | ↑ +30% |
| AMERIHEALTH | LOCAL HMO | $8,562.79 | ↑ +31% |
| HORIZON | PPO | $8,602.65 | ↑ +31% |
| QUALCARE | WORKERS COMP | $8,770.08 | ↑ +34% |
| AMERIHEALTH | REGIONAL HMO | $9,698.91 | ↑ +48% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +52% |
| UNITED HEALTHCARE | HMO | $10,105.00 | ↑ +54% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Tonsillectomy (child under 12) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $6,966.64 | $588.47 – $9,272.70 |
| Ocean University Medical Center | Brick | $6,465.11 | $566.98 – $9,178.00 |