Biopsy of inestine 44100 at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$1,024.64
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.
$2,077.00
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.
$215.78 with KARNA vs $9,933.00 with BRIGHTON HEALTH PLAN — 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 | $215.78 | ↓ -79% |
| CLOVER | MEDICARE ADVANTAGE | $373.86 | ↓ -64% |
| AETNA | MANAGED MEDICAID | $384.25 | ↓ -62% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $425.79 | ↓ -58% |
| HORIZON | MANAGED MEDICAID | $903.00 | ↓ -12% |
| WELLCARE | MEDICARE ADVANTAGE | $1,024.64 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $1,024.64 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,024.64 | ↑ +0% |
| VACCN | ALL PRODUCTS | $1,024.64 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,075.87 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $1,116.86 | ↑ +9% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↑ +16% |
| UNITED HEALTHCARE | DSNP | $1,229.57 | ↑ +20% |
| HORIZON | PIP | $1,352.13 | ↑ +32% |
| HORIZON | WORKERS COMP | $1,395.54 | ↑ +36% |
| HORIZON | OMNIA | $1,499.80 | ↑ +46% |
| QUALCARE | HMO | $1,525.00 | ↑ +49% |
| BERGEN RISK | ALL PRODUCTS | $1,557.75 | ↑ +52% |
| AETNA | ASA | $1,626.29 | ↑ +59% |
| CIGNA | BH | $1,661.60 | ↑ +62% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $1,765.45 | ↑ +72% |
| HORIZON | SHP | $1,782.90 | ↑ +74% |
| AMERIHEALTH | LOCAL HMO | $1,803.67 | ↑ +76% |
| HORIZON | INDEMNITY | $1,848.53 | ↑ +80% |
| HORIZON | HMO | $1,849.78 | ↑ +81% |
| QUALCARE | PPO | $1,885.92 | ↑ +84% |
| QUALCARE | WORKERS COMP | $1,885.92 | ↑ +84% |
| HORIZON | PPO | $1,898.79 | ↑ +85% |
| AMERIHEALTH | REGIONAL HMO | $2,042.94 | ↑ +99% |
| CIGNA | HMO | $2,249.00 | ↑ +119% |
| CIGNA | PPO | $2,518.00 | ↑ +146% |
| OXFORD | ALL PRODUCTS | $6,189.00 | ↑ +504% |
| UNITED HEALTHCARE | HMO | $7,601.00 | ↑ +642% |
| AETNA | PPO | $9,383.00 | ↑ +816% |
| AETNA | HMO | $9,383.00 | ↑ +816% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +869% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of inestine 44100 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $1,037.75 | $1,037.75 – $1,245.30 |
| Hackensack University Medical Center | Hackensack | $1,104.13 | $221.89 – $1,159.33 |
| Ocean University Medical Center | Brick | $1,024.64 | $215.78 – $1,229.57 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $1,038.65 | $114.00 – $1,038.65 |
| Jersey Shore University Medical Center | Neptune City | $1,037.75 | $215.78 – $1,245.30 |
| Palisades Medical Center | North Bergen | $1,104.13 | $221.89 – $1,203.50 |
| Raritan Bay Medical Center | Perth Amboy | $1,038.65 | $221.89 – $1,246.38 |
| Riverview Medical Center | Red Bank | $1,037.75 | $215.78 – $1,245.30 |