healthcosts.net
Total Knee Replacement at Bayshore Medical Center
727 North Beers St., Holmdel, NJ · Hackensack Meridian Health · · NPI 1760994412
$14,241.77
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.
$17,531.00
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.
$1,613.00 with HORIZON vs $26,868.00 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 |
|---|---|---|---|
| HORIZON | MANAGED MEDICAID | $1,613.00 | ↓ -89% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $2,379.00 | ↓ -83% |
| AETNA | MANAGED MEDICAID | $2,875.08 | ↓ -80% |
| CLOVER | MEDICARE ADVANTAGE | $3,155.58 | ↓ -78% |
| AETNA | MEDICARE ADVANTAGE | $3,173.11 | ↓ -78% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $3,278.30 | ↓ -77% |
| QUALCARE | HMO | $6,256.00 | ↓ -56% |
| HORIZON | OMNIA | $6,984.00 | ↓ -51% |
| HORIZON | SHP | $8,004.00 | ↓ -44% |
| AETNA | PPO | $8,419.00 | ↓ -41% |
| AETNA | HMO | $8,419.00 | ↓ -41% |
| HORIZON | HMO | $8,627.00 | ↓ -39% |
| HORIZON | INDEMNITY | $8,748.00 | ↓ -39% |
| HORIZON | PPO | $8,830.00 | ↓ -38% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↓ -30% |
| QUALCARE | PPO | $10,231.00 | ↓ -28% |
| QUALCARE | WORKERS COMP | $10,822.00 | ↓ -24% |
| HORIZON | PIP | $11,307.50 | ↓ -21% |
| HORIZON | WORKERS COMP | $11,307.50 | ↓ -21% |
| BERGEN RISK | ALL PRODUCTS | $13,148.25 | ↓ -8% |
| AETNA | ASA | $13,726.77 | ↓ -4% |
| AMERIHEALTH | LOCAL HMO | $13,972.00 | ↓ -2% |
| CIGNA | BH | $14,024.80 | ↓ -2% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $14,241.77 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $14,241.77 | ↑ +0% |
| VACCN | ALL PRODUCTS | $14,241.77 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $14,241.77 | ↑ +0% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $14,901.35 | ↑ +5% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $14,953.86 | ↑ +5% |
| AMERIHEALTH | REGIONAL HMO | $15,795.00 | ↑ +11% |
| UNITED HEALTHCARE | DSNP | $17,090.12 | ↑ +20% |
| CIGNA | PPO | $18,427.00 | ↑ +29% |
| CIGNA | HMO | $18,427.00 | ↑ +29% |
| OXFORD | ALL PRODUCTS | $21,455.00 | ↑ +51% |
| UNITED HEALTHCARE | HMO | $26,868.00 | ↑ +89% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Total Knee Replacement at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hackensack University Medical Center | Hackensack | $15,152.74 | $2,611.44 – $15,910.38 |
| Ocean University Medical Center | Brick | $14,061.89 | $2,489.40 – $22,177.73 |