Aco annual medicare visit (awv), initial g0438aco at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$206.14
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.
$517.00
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.
$93.06 with CLOVER vs $508.52 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 |
|---|---|---|---|
| CLOVER | MEDICARE ADVANTAGE | $93.06 | ↓ -55% |
| AETNA | MANAGED MEDICAID | $95.65 | ↓ -54% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $105.99 | ↓ -49% |
| AMERIGROUP | MANAGED MEDICAID | $206.14 | ↑ +0% |
| VACCN | ALL PRODUCTS | $206.14 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $206.14 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $206.14 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $216.45 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $224.69 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $247.37 | ↑ +20% |
| KARNA | MEDICARE ADVANTAGE | $289.84 | ↑ +41% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $304.51 | ↑ +48% |
| HORIZON | MANAGED MEDICAID | $327.67 | ↑ +59% |
| HORIZON | PIP | $336.57 | ↑ +63% |
| HORIZON | WORKERS COMP | $347.37 | ↑ +69% |
| OXFORD | ALL PRODUCTS | $367.54 | ↑ +78% |
| HORIZON | OMNIA | $373.33 | ↑ +81% |
| BERGEN RISK | ALL PRODUCTS | $387.75 | ↑ +88% |
| UNITED HEALTHCARE | HMO | $401.61 | ↑ +95% |
| AETNA | ASA | $404.81 | ↑ +96% |
| CIGNA | BH | $413.60 | ↑ +101% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $439.45 | ↑ +113% |
| HORIZON | SHP | $443.79 | ↑ +115% |
| AMERIHEALTH | LOCAL HMO | $448.96 | ↑ +118% |
| HORIZON | INDEMNITY | $460.13 | ↑ +123% |
| HORIZON | HMO | $460.44 | ↑ +123% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $465.30 | ↑ +126% |
| AETNA | HMO | $465.40 | ↑ +126% |
| AETNA | PPO | $465.40 | ↑ +126% |
| QUALCARE | HMO | $469.44 | ↑ +128% |
| QUALCARE | PPO | $469.44 | ↑ +128% |
| QUALCARE | WORKERS COMP | $469.44 | ↑ +128% |
| HORIZON | PPO | $472.64 | ↑ +129% |
| CIGNA | PPO | $494.41 | ↑ +140% |
| CIGNA | HMO | $494.41 | ↑ +140% |
| AMERIHEALTH | REGIONAL HMO | $508.52 | ↑ +147% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Aco annual medicare visit (awv), initial g0438aco at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $206.14 | $206.14 – $300.52 |
| Jersey Shore University Medical Center | Neptune City | $206.14 | $164.91 – $289.84 |
| Palisades Medical Center | North Bergen | $206.14 | $206.14 – $300.52 |
| Raritan Bay Medical Center | Perth Amboy | $206.14 | $206.14 – $300.52 |
| Riverview Medical Center | Red Bank | $206.14 | $206.14 – $289.84 |