Biopsy vestibule of mouth 40808 at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$556.55
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.
$1,134.00
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.
$0.01 with CIGNA 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 |
|---|---|---|---|
| CIGNA | PPO | $0.01 | ↓ -100% |
| CIGNA | HMO | $0.01 | ↓ -100% |
| KARNA | MEDICARE ADVANTAGE | $187.20 | ↓ -66% |
| CLOVER | MEDICARE ADVANTAGE | $204.12 | ↓ -63% |
| AETNA | MANAGED MEDICAID | $209.79 | ↓ -62% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $232.47 | ↓ -58% |
| WELLCARE | MEDICARE ADVANTAGE | $556.55 | ↑ +0% |
| VACCN | ALL PRODUCTS | $556.55 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $556.55 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $556.55 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $584.38 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $606.64 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $667.86 | ↑ +20% |
| HORIZON | PIP | $738.23 | ↑ +33% |
| HORIZON | WORKERS COMP | $761.93 | ↑ +37% |
| HORIZON | OMNIA | $818.86 | ↑ +47% |
| BERGEN RISK | ALL PRODUCTS | $850.50 | ↑ +53% |
| AETNA | ASA | $887.92 | ↑ +60% |
| CIGNA | BH | $907.20 | ↑ +63% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $963.90 | ↑ +73% |
| HORIZON | SHP | $973.43 | ↑ +75% |
| AMERIHEALTH | LOCAL HMO | $984.77 | ↑ +77% |
| HORIZON | INDEMNITY | $1,009.26 | ↑ +81% |
| HORIZON | HMO | $1,009.94 | ↑ +81% |
| QUALCARE | PPO | $1,029.67 | ↑ +85% |
| QUALCARE | WORKERS COMP | $1,029.67 | ↑ +85% |
| HORIZON | PPO | $1,036.70 | ↑ +86% |
| AMERIHEALTH | REGIONAL HMO | $1,115.40 | ↑ +100% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↑ +114% |
| QUALCARE | HMO | $1,525.00 | ↑ +174% |
| HORIZON | MANAGED MEDICAID | $1,679.00 | ↑ +202% |
| OXFORD | ALL PRODUCTS | $2,837.00 | ↑ +410% |
| UNITED HEALTHCARE | HMO | $3,352.00 | ↑ +502% |
| AETNA | PPO | $9,383.00 | ↑ +1586% |
| AETNA | HMO | $9,383.00 | ↑ +1586% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +1685% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy vestibule of mouth 40808 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $563.67 | $563.67 – $676.40 |
| Hackensack University Medical Center | Hackensack | $599.72 | $194.80 – $636.27 |
| Ocean University Medical Center | Brick | $556.55 | $187.20 – $667.86 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $564.16 | $31.46 – $564.16 |
| Jersey Shore University Medical Center | Neptune City | $563.67 | $187.20 – $676.40 |
| Palisades Medical Center | North Bergen | $599.72 | $194.80 – $653.70 |
| Raritan Bay Medical Center | Perth Amboy | $564.16 | $194.80 – $676.99 |
| Riverview Medical Center | Red Bank | $563.67 | $187.20 – $676.40 |