Biopsy of heart lining at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$3,439.84
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.
$6,272.00
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.
$1,081.12 with KARNA vs $14,007.00 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 | $1,081.12 | ↓ -69% |
| CLOVER | MEDICARE ADVANTAGE | $1,128.96 | ↓ -67% |
| AETNA | MANAGED MEDICAID | $1,160.32 | ↓ -66% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -65% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,285.76 | ↓ -63% |
| HORIZON | MANAGED MEDICAID | $2,941.00 | ↓ -15% |
| VACCN | ALL PRODUCTS | $3,439.84 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,439.84 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,439.84 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,439.84 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,611.83 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $3,749.43 | ↑ +9% |
| HORIZON | PIP | $4,083.07 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $4,127.81 | ↑ +20% |
| HORIZON | WORKERS COMP | $4,214.16 | ↑ +23% |
| HORIZON | OMNIA | $4,529.01 | ↑ +32% |
| BERGEN RISK | ALL PRODUCTS | $4,704.00 | ↑ +37% |
| AETNA | ASA | $4,910.98 | ↑ +43% |
| CIGNA | BH | $5,017.60 | ↑ +46% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,331.20 | ↑ +55% |
| HORIZON | SHP | $5,383.88 | ↑ +57% |
| AMERIHEALTH | LOCAL HMO | $5,446.60 | ↑ +58% |
| HORIZON | INDEMNITY | $5,582.08 | ↑ +62% |
| HORIZON | HMO | $5,585.84 | ↑ +62% |
| QUALCARE | HMO | $5,694.98 | ↑ +66% |
| QUALCARE | WORKERS COMP | $5,694.98 | ↑ +66% |
| QUALCARE | PPO | $5,694.98 | ↑ +66% |
| HORIZON | PPO | $5,733.86 | ↑ +67% |
| CIGNA | PPO | $5,997.91 | ↑ +74% |
| CIGNA | HMO | $5,997.91 | ↑ +74% |
| AMERIHEALTH | REGIONAL HMO | $6,169.14 | ↑ +79% |
| AETNA | HMO | $9,960.00 | ↑ +190% |
| AETNA | PPO | $9,960.00 | ↑ +190% |
| OXFORD | ALL PRODUCTS | $11,243.00 | ↑ +227% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $11,920.00 | ↑ +247% |
| UNITED HEALTHCARE | HMO | $14,007.00 | ↑ +307% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of heart lining at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $3,483.84 | $3,483.84 – $4,180.61 |
| Hackensack University Medical Center | Hackensack | $3,706.68 | $1,132.92 – $3,892.02 |
| Ocean University Medical Center | Brick | $3,439.84 | $1,081.12 – $14,806.00 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $3,486.86 | $1,132.92 – $14,806.00 |
| Jersey Shore University Medical Center | Neptune City | $3,483.84 | $1,081.12 – $4,180.61 |
| Palisades Medical Center | North Bergen | $3,706.68 | $1,132.92 – $4,040.29 |
| Raritan Bay Medical Center | Perth Amboy | $3,486.86 | $1,132.92 – $4,184.24 |
| Riverview Medical Center | Red Bank | $3,483.84 | $1,081.12 – $4,180.61 |