Breast punct aspir cyst, bil at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$768.94
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.
$2,328.00
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.
$85.42 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 | $85.42 | ↓ -89% |
| CLOVER | MEDICARE ADVANTAGE | $419.04 | ↓ -46% |
| AETNA | MANAGED MEDICAID | $430.68 | ↓ -44% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $477.24 | ↓ -38% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $768.94 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $768.94 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $768.94 | ↑ +0% |
| VACCN | ALL PRODUCTS | $768.94 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $807.39 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $838.14 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $922.73 | ↑ +20% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↑ +55% |
| HORIZON | PIP | $1,515.53 | ↑ +97% |
| QUALCARE | HMO | $1,525.00 | ↑ +98% |
| HORIZON | WORKERS COMP | $1,564.18 | ↑ +103% |
| HORIZON | MANAGED MEDICAID | $1,679.00 | ↑ +118% |
| HORIZON | OMNIA | $1,681.05 | ↑ +119% |
| BERGEN RISK | ALL PRODUCTS | $1,746.00 | ↑ +127% |
| AETNA | ASA | $1,822.82 | ↑ +137% |
| CIGNA | BH | $1,862.40 | ↑ +142% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $1,978.80 | ↑ +157% |
| HORIZON | SHP | $1,998.36 | ↑ +160% |
| AMERIHEALTH | LOCAL HMO | $2,021.64 | ↑ +163% |
| HORIZON | INDEMNITY | $2,071.92 | ↑ +169% |
| HORIZON | HMO | $2,073.32 | ↑ +170% |
| QUALCARE | PPO | $2,113.82 | ↑ +175% |
| QUALCARE | WORKERS COMP | $2,113.82 | ↑ +175% |
| HORIZON | PPO | $2,128.26 | ↑ +177% |
| CIGNA | HMO | $2,249.00 | ↑ +192% |
| AMERIHEALTH | REGIONAL HMO | $2,289.82 | ↑ +198% |
| CIGNA | PPO | $2,518.00 | ↑ +227% |
| OXFORD | ALL PRODUCTS | $4,125.00 | ↑ +436% |
| UNITED HEALTHCARE | HMO | $4,986.00 | ↑ +548% |
| AETNA | PPO | $9,383.00 | ↑ +1120% |
| AETNA | HMO | $9,383.00 | ↑ +1120% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +1192% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Breast punct aspir cyst, bil at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $778.78 | $778.78 – $934.53 |
| Hackensack University Medical Center | Hackensack | $828.59 | $87.62 – $870.02 |
| Ocean University Medical Center | Brick | $768.94 | $85.42 – $922.73 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $779.45 | $87.62 – $779.45 |
| Jersey Shore University Medical Center | Neptune City | $778.78 | $85.42 – $934.53 |
| Palisades Medical Center | North Bergen | $828.59 | $87.62 – $903.16 |
| Raritan Bay Medical Center | Perth Amboy | $779.45 | $87.62 – $935.34 |
| Riverview Medical Center | Red Bank | $778.78 | $85.42 – $934.53 |