C-1 esterase, berinert at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$75.86
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.
$351.75
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.
$63.32 with CLOVER vs $321.57 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 |
|---|---|---|---|
| CLOVER | MEDICARE ADVANTAGE | $63.32 | ↓ -17% |
| HORIZON | MANAGED MEDICAID | $64.48 | ↓ -15% |
| VACCN | ALL PRODUCTS | $75.86 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $75.86 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $79.65 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $82.69 | ↑ +9% |
| KARNA | MEDICARE ADVANTAGE | $83.82 | ↑ +10% |
| UNITED HEALTHCARE | DSNP | $91.03 | ↑ +20% |
| AMERIHEALTH | LOCAL HMO | $102.32 | ↑ +35% |
| AMERIHEALTH | REGIONAL HMO | $111.93 | ↑ +48% |
| WELLCARE | MEDICARE ADVANTAGE | $158.29 | ↑ +109% |
| WELLCARE | MANAGED MEDICAID | $158.29 | ↑ +109% |
| AETNA | MANAGED MEDICAID | $172.36 | ↑ +127% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $175.88 | ↑ +132% |
| AMERIGROUP | MANAGED MEDICAID | $175.88 | ↑ +132% |
| UNITED HEALTHCARE | HMO | $190.30 | ↑ +151% |
| OXFORD | ALL PRODUCTS | $190.30 | ↑ +151% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $207.18 | ↑ +173% |
| BERGEN RISK | ALL PRODUCTS | $211.05 | ↑ +178% |
| AETNA | HMO | $213.16 | ↑ +181% |
| AETNA | PPO | $213.16 | ↑ +181% |
| HORIZON | PIP | $228.99 | ↑ +202% |
| HORIZON | WORKERS COMP | $236.34 | ↑ +212% |
| HORIZON | OMNIA | $254.00 | ↑ +235% |
| AETNA | ASA | $275.42 | ↑ +263% |
| CIGNA | BH | $281.40 | ↑ +271% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $298.99 | ↑ +294% |
| HORIZON | SHP | $301.94 | ↑ +298% |
| HORIZON | INDEMNITY | $313.06 | ↑ +313% |
| HORIZON | HMO | $313.27 | ↑ +313% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $316.58 | ↑ +317% |
| QUALCARE | HMO | $319.39 | ↑ +321% |
| HORIZON | PPO | $321.57 | ↑ +324% |
| QUALCARE | WORKERS COMP | not published by hospital | — |
| QUALCARE | PPO | not published by hospital | — |
| CIGNA | PPO | not published by hospital | — |
| CIGNA | HMO | not published by hospital | — |