Biopsy roof of mouth at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$1,618.86
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.
?
What you pay up front if you don't use insurance.
$2,955.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$231.44 with KARNA vs $9,933.00 with BRIGHTON HEALTH PLAN — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $231.44 | ↓ -86% |
| CLOVER | MEDICARE ADVANTAGE | $531.90 | ↓ -67% |
| AETNA | MANAGED MEDICAID | $546.68 | ↓ -66% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $605.78 | ↓ -63% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -27% |
| QUALCARE | HMO | $1,525.00 | ↓ -6% |
| WELLCARE | MANAGED MEDICAID | $1,618.86 | ↑ +0% |
| VACCN | ALL PRODUCTS | $1,618.86 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $1,618.86 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,618.86 | ↑ +0% |
| HORIZON | MANAGED MEDICAID | $1,679.00 | ↑ +4% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,699.80 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $1,764.56 | ↑ +9% |
| HORIZON | PIP | $1,923.71 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $1,942.63 | ↑ +20% |
| HORIZON | WORKERS COMP | $1,985.46 | ↑ +23% |
| HORIZON | OMNIA | $2,133.81 | ↑ +32% |
| BERGEN RISK | ALL PRODUCTS | $2,216.25 | ↑ +37% |
| CIGNA | HMO | $2,249.00 | ↑ +39% |
| AETNA | ASA | $2,313.77 | ↑ +43% |
| CIGNA | BH | $2,364.00 | ↑ +46% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $2,511.75 | ↑ +55% |
| CIGNA | PPO | $2,518.00 | ↑ +56% |
| HORIZON | SHP | $2,536.57 | ↑ +57% |
| AMERIHEALTH | LOCAL HMO | $2,566.12 | ↑ +59% |
| HORIZON | INDEMNITY | $2,629.95 | ↑ +62% |
| HORIZON | HMO | $2,631.72 | ↑ +63% |
| QUALCARE | PPO | $2,683.14 | ↑ +66% |
| QUALCARE | WORKERS COMP | $2,683.14 | ↑ +66% |
| HORIZON | PPO | $2,701.46 | ↑ +67% |
| AMERIHEALTH | REGIONAL HMO | $2,906.54 | ↑ +80% |
| OXFORD | ALL PRODUCTS | $6,189.00 | ↑ +282% |
| UNITED HEALTHCARE | HMO | $7,601.00 | ↑ +370% |
| AETNA | PPO | $9,383.00 | ↑ +480% |
| AETNA | HMO | $9,383.00 | ↑ +480% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +514% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy roof of mouth at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $1,639.57 | $1,639.57 – $1,967.48 |
| Hackensack University Medical Center | Hackensack | $1,744.44 | $240.56 – $1,831.67 |
| Ocean University Medical Center | Brick | $1,618.86 | $231.44 – $1,942.63 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $1,640.99 | $50.40 – $1,640.99 |
| Jersey Shore University Medical Center | Neptune City | $1,639.57 | $231.44 – $1,967.48 |
| Palisades Medical Center | North Bergen | $1,744.44 | $240.56 – $1,901.44 |
| Raritan Bay Medical Center | Perth Amboy | $1,640.99 | $240.56 – $1,969.19 |
| Riverview Medical Center | Red Bank | $1,639.57 | $231.44 – $1,967.48 |