Biliary endoscopy thru skin at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$11,378.21
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.
$12,615.00
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.
$746.65 with KARNA vs $23,291.00 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 |
|---|---|---|---|
| KARNA | MEDICARE ADVANTAGE | $746.65 | ↓ -93% |
| HORIZON | MANAGED MEDICAID | $1,679.00 | ↓ -85% |
| CLOVER | MEDICARE ADVANTAGE | $2,270.70 | ↓ -80% |
| AETNA | MANAGED MEDICAID | $2,333.78 | ↓ -79% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $2,379.00 | ↓ -79% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $2,586.08 | ↓ -77% |
| HORIZON | OMNIA | $7,049.00 | ↓ -38% |
| HORIZON | SHP | $7,963.00 | ↓ -30% |
| HORIZON | PIP | $8,212.37 | ↓ -28% |
| HORIZON | WORKERS COMP | $8,476.02 | ↓ -26% |
| HORIZON | INDEMNITY | $8,703.00 | ↓ -24% |
| HORIZON | HMO | $8,706.00 | ↓ -23% |
| HORIZON | PPO | $8,936.00 | ↓ -21% |
| AETNA | PPO | $9,383.00 | ↓ -18% |
| AETNA | HMO | $9,383.00 | ↓ -18% |
| BERGEN RISK | ALL PRODUCTS | $9,461.25 | ↓ -17% |
| AETNA | ASA | $9,877.55 | ↓ -13% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↓ -13% |
| CIGNA | BH | $10,092.00 | ↓ -11% |
| QUALCARE | WORKERS COMP | $10,197.00 | ↓ -10% |
| QUALCARE | PPO | $10,197.00 | ↓ -10% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $10,722.75 | ↓ -6% |
| AMERIHEALTH | LOCAL HMO | $10,954.87 | ↓ -4% |
| CIGNA | PPO | $11,339.62 | ↓ -0% |
| CIGNA | HMO | $11,339.62 | ↓ -0% |
| VACCN | ALL PRODUCTS | $11,378.21 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $11,378.21 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $11,378.21 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $11,378.21 | ↑ +0% |
| QUALCARE | HMO | $11,454.42 | ↑ +1% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $11,947.12 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $12,402.25 | ↑ +9% |
| AMERIHEALTH | REGIONAL HMO | $12,408.11 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $13,653.86 | ↑ +20% |
| OXFORD | ALL PRODUCTS | $18,565.00 | ↑ +63% |
| UNITED HEALTHCARE | HMO | $23,291.00 | ↑ +105% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Biliary endoscopy thru skin at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $11,523.76 | $11,523.76 – $13,828.52 |
| Hackensack University Medical Center | Hackensack | $12,260.88 | $762.10 – $12,873.92 |
| Ocean University Medical Center | Brick | $11,378.21 | $746.65 – $13,653.86 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $11,533.76 | $762.10 – $11,533.76 |
| Jersey Shore University Medical Center | Neptune City | $11,523.76 | $746.65 – $13,828.52 |
| Palisades Medical Center | North Bergen | $12,260.88 | $762.10 – $13,364.36 |
| Raritan Bay Medical Center | Perth Amboy | $11,533.76 | $762.10 – $13,840.51 |
| Riverview Medical Center | Red Bank | $11,523.76 | $746.65 – $13,828.52 |