Bx perianal mass at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$996.39
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.
$2,812.00
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.
$506.16 with CLOVER 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 |
|---|---|---|---|
| CLOVER | MEDICARE ADVANTAGE | $506.16 | ↓ -49% |
| AETNA | MANAGED MEDICAID | $520.22 | ↓ -48% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $576.46 | ↓ -42% |
| WELLCARE | MANAGED MEDICAID | $996.39 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $996.39 | ↑ +0% |
| VACCN | ALL PRODUCTS | $996.39 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $996.39 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,046.21 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $1,086.06 | ↑ +9% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $1,195.67 | ↑ +20% |
| QUALCARE | HMO | $1,525.00 | ↑ +53% |
| HORIZON | MANAGED MEDICAID | $1,679.00 | ↑ +69% |
| HORIZON | PIP | $1,830.61 | ↑ +84% |
| HORIZON | WORKERS COMP | $1,889.38 | ↑ +90% |
| HORIZON | OMNIA | $2,030.55 | ↑ +104% |
| BERGEN RISK | ALL PRODUCTS | $2,109.00 | ↑ +112% |
| AETNA | ASA | $2,201.80 | ↑ +121% |
| CIGNA | BH | $2,249.60 | ↑ +126% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $2,390.20 | ↑ +140% |
| HORIZON | SHP | $2,413.82 | ↑ +142% |
| AMERIHEALTH | LOCAL HMO | $2,441.94 | ↑ +145% |
| HORIZON | INDEMNITY | $2,502.68 | ↑ +151% |
| HORIZON | HMO | $2,504.37 | ↑ +151% |
| CIGNA | HMO | $2,527.71 | ↑ +154% |
| CIGNA | PPO | $2,527.71 | ↑ +154% |
| QUALCARE | PPO | $2,553.30 | ↑ +156% |
| QUALCARE | WORKERS COMP | $2,553.30 | ↑ +156% |
| HORIZON | PPO | $2,570.73 | ↑ +158% |
| AMERIHEALTH | REGIONAL HMO | $2,765.88 | ↑ +178% |
| OXFORD | ALL PRODUCTS | $4,125.00 | ↑ +314% |
| UNITED HEALTHCARE | HMO | $4,986.00 | ↑ +400% |
| AETNA | PPO | $9,383.00 | ↑ +842% |
| AETNA | HMO | $9,383.00 | ↑ +842% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +897% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Bx perianal mass at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $1,009.14 | $1,009.14 – $1,210.96 |
| Hackensack University Medical Center | Hackensack | $1,073.68 | $858.95 – $1,127.37 |
| Ocean University Medical Center | Brick | $996.39 | $911.71 – $1,195.67 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $1,010.01 | $911.71 – $1,010.01 |
| Jersey Shore University Medical Center | Neptune City | $1,009.14 | $1,009.14 – $1,210.96 |
| Palisades Medical Center | North Bergen | $1,073.68 | $1,073.68 – $1,170.32 |
| Raritan Bay Medical Center | Perth Amboy | $1,010.01 | $1,010.01 – $1,212.01 |
| Riverview Medical Center | Red Bank | $1,009.14 | $1,009.14 – $1,210.96 |