Bx of breast open 19101 at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$4,184.94
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.
$6,657.00
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.
$465.46 with KARNA 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 |
|---|---|---|---|
| KARNA | MEDICARE ADVANTAGE | $465.46 | ↓ -89% |
| HORIZON | MANAGED MEDICAID | $1,188.00 | ↓ -72% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -72% |
| CLOVER | MEDICARE ADVANTAGE | $1,198.26 | ↓ -71% |
| AETNA | MANAGED MEDICAID | $1,231.55 | ↓ -71% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,364.69 | ↓ -67% |
| QUALCARE | HMO | $1,982.00 | ↓ -53% |
| CIGNA | HMO | $3,133.00 | ↓ -25% |
| CIGNA | PPO | $3,508.00 | ↓ -16% |
| WELLCARE | MEDICARE ADVANTAGE | $4,184.94 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $4,184.94 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,184.94 | ↑ +0% |
| VACCN | ALL PRODUCTS | $4,184.94 | ↑ +0% |
| HORIZON | PIP | $4,333.71 | ↑ +4% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,394.19 | ↑ +5% |
| HORIZON | WORKERS COMP | $4,472.84 | ↑ +7% |
| AETNA | MEDICARE ADVANTAGE | $4,561.59 | ↑ +9% |
| HORIZON | OMNIA | $4,807.02 | ↑ +15% |
| BERGEN RISK | ALL PRODUCTS | $4,992.75 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $5,021.93 | ↑ +20% |
| AETNA | ASA | $5,212.43 | ↑ +25% |
| CIGNA | BH | $5,325.60 | ↑ +27% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,658.45 | ↑ +35% |
| HORIZON | SHP | $5,714.37 | ↑ +37% |
| AMERIHEALTH | LOCAL HMO | $5,780.94 | ↑ +38% |
| HORIZON | INDEMNITY | $5,924.73 | ↑ +42% |
| HORIZON | HMO | $5,928.72 | ↑ +42% |
| QUALCARE | PPO | $6,044.56 | ↑ +44% |
| QUALCARE | WORKERS COMP | $6,044.56 | ↑ +44% |
| HORIZON | PPO | $6,085.83 | ↑ +45% |
| AMERIHEALTH | REGIONAL HMO | $6,547.83 | ↑ +56% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +97% |
| AETNA | PPO | $9,383.00 | ↑ +124% |
| AETNA | HMO | $9,383.00 | ↑ +124% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +137% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +144% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Bx of breast open 19101 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $4,238.48 | $4,238.48 – $5,086.17 |
| Hackensack University Medical Center | Hackensack | $4,509.59 | $479.73 – $4,735.07 |
| Ocean University Medical Center | Brick | $4,184.94 | $465.46 – $5,021.93 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $4,242.15 | $256.20 – $4,242.15 |
| Jersey Shore University Medical Center | Neptune City | $4,238.48 | $465.46 – $5,086.17 |
| Palisades Medical Center | North Bergen | $4,509.59 | $479.73 – $4,915.45 |
| Raritan Bay Medical Center | Perth Amboy | $4,242.15 | $479.73 – $5,090.58 |
| Riverview Medical Center | Red Bank | $4,238.48 | $465.46 – $5,086.17 |