Biopsy of hip joint at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$1,749.06
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.
$6,371.00
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.
$1,146.78 with CLOVER vs $10,216.00 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 |
|---|---|---|---|
| CLOVER | MEDICARE ADVANTAGE | $1,146.78 | ↓ -34% |
| AETNA | MANAGED MEDICAID | $1,178.64 | ↓ -33% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -32% |
| KARNA | MEDICARE ADVANTAGE | $1,228.75 | ↓ -30% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,306.06 | ↓ -25% |
| HORIZON | MANAGED MEDICAID | $1,361.00 | ↓ -22% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,749.06 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $1,749.06 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $1,749.06 | ↑ +0% |
| VACCN | ALL PRODUCTS | $1,749.06 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,836.51 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $1,906.47 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $2,098.87 | ↑ +20% |
| QUALCARE | HMO | $2,255.00 | ↑ +29% |
| CIGNA | HMO | $3,586.00 | ↑ +105% |
| CIGNA | PPO | $4,011.00 | ↑ +129% |
| HORIZON | PIP | $4,147.52 | ↑ +137% |
| HORIZON | WORKERS COMP | $4,280.67 | ↑ +145% |
| HORIZON | OMNIA | $4,600.50 | ↑ +163% |
| BERGEN RISK | ALL PRODUCTS | $4,778.25 | ↑ +173% |
| AETNA | ASA | $4,988.49 | ↑ +185% |
| CIGNA | BH | $5,096.80 | ↑ +191% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,415.35 | ↑ +210% |
| HORIZON | SHP | $5,468.87 | ↑ +213% |
| AMERIHEALTH | LOCAL HMO | $5,532.58 | ↑ +216% |
| HORIZON | INDEMNITY | $5,670.19 | ↑ +224% |
| HORIZON | HMO | $5,674.01 | ↑ +224% |
| QUALCARE | PPO | $5,784.87 | ↑ +231% |
| QUALCARE | WORKERS COMP | $5,784.87 | ↑ +231% |
| HORIZON | PPO | $5,824.37 | ↑ +233% |
| AMERIHEALTH | REGIONAL HMO | $6,266.52 | ↑ +258% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +372% |
| AETNA | HMO | $9,383.00 | ↑ +436% |
| AETNA | PPO | $9,383.00 | ↑ +436% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +468% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +484% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of hip joint at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $1,771.43 | $1,771.43 – $2,125.72 |
| Hackensack University Medical Center | Hackensack | $1,884.74 | $1,272.91 – $1,978.98 |
| Ocean University Medical Center | Brick | $1,749.06 | $1,228.75 – $2,098.87 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $1,772.97 | $798.00 – $1,772.97 |
| Jersey Shore University Medical Center | Neptune City | $1,771.43 | $1,228.75 – $2,125.72 |
| Palisades Medical Center | North Bergen | $1,884.74 | $1,272.91 – $2,054.37 |
| Raritan Bay Medical Center | Perth Amboy | $1,772.97 | $1,272.91 – $2,127.56 |
| Riverview Medical Center | Red Bank | $1,771.43 | $1,228.75 – $2,125.72 |