Bx pleura pq ndl at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$1,770.73
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.
$3,858.00
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.
$167.75 with KARNA vs $10,149.00 with HORIZON — 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 | $167.75 | ↓ -91% |
| CLOVER | MEDICARE ADVANTAGE | $694.44 | ↓ -61% |
| AETNA | MANAGED MEDICAID | $713.73 | ↓ -60% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $790.89 | ↓ -55% |
| WELLCARE | MANAGED MEDICAID | $1,770.73 | ↑ +0% |
| VACCN | ALL PRODUCTS | $1,770.73 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,770.73 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $1,770.73 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,859.26 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $1,930.09 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $2,124.87 | ↑ +20% |
| CIGNA | HMO | $2,249.00 | ↑ +27% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $2,272.36 | ↑ +28% |
| HORIZON | MANAGED MEDICAID | $2,445.20 | ↑ +38% |
| HORIZON | PIP | $2,511.56 | ↑ +42% |
| CIGNA | PPO | $2,518.00 | ↑ +42% |
| OXFORD | ALL PRODUCTS | $2,742.65 | ↑ +55% |
| BERGEN RISK | ALL PRODUCTS | $2,893.50 | ↑ +63% |
| UNITED HEALTHCARE | HMO | $2,996.89 | ↑ +69% |
| AETNA | ASA | $3,020.81 | ↑ +71% |
| CIGNA | BH | $3,086.40 | ↑ +74% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $3,279.30 | ↑ +85% |
| AMERIHEALTH | LOCAL HMO | $3,350.29 | ↑ +89% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $3,472.20 | ↑ +96% |
| AETNA | PPO | $3,472.97 | ↑ +96% |
| AETNA | HMO | $3,472.97 | ↑ +96% |
| QUALCARE | HMO | $3,503.06 | ↑ +98% |
| QUALCARE | PPO | $3,503.06 | ↑ +98% |
| QUALCARE | WORKERS COMP | $3,503.06 | ↑ +98% |
| AMERIHEALTH | REGIONAL HMO | $3,794.73 | ↑ +114% |
| HORIZON | OMNIA | $6,368.00 | ↑ +260% |
| HORIZON | SHP | $7,264.00 | ↑ +310% |
| HORIZON | INDEMNITY | $7,867.00 | ↑ +344% |
| HORIZON | HMO | $7,869.00 | ↑ +344% |
| HORIZON | PPO | $8,077.00 | ↑ +356% |
| HORIZON | WORKERS COMP | $10,149.00 | ↑ +473% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Bx pleura pq ndl at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $1,793.38 | $1,793.38 – $2,152.05 |
| Hackensack University Medical Center | Hackensack | $1,908.09 | $172.03 – $2,003.50 |
| Ocean University Medical Center | Brick | $1,770.73 | $167.75 – $2,124.87 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $1,794.93 | $58.80 – $1,794.93 |
| Jersey Shore University Medical Center | Neptune City | $1,793.38 | $167.75 – $2,152.05 |
| Palisades Medical Center | North Bergen | $1,908.09 | $57.92 – $2,079.82 |
| Raritan Bay Medical Center | Perth Amboy | $1,794.93 | $73.50 – $2,153.92 |
| Riverview Medical Center | Red Bank | $1,793.38 | $167.75 – $2,152.05 |