Egd w/transmural drain cyst at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$6,505.71
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.
$5,990.00
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.
$791.46 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 | $791.46 | ↓ -88% |
| CLOVER | MEDICARE ADVANTAGE | $1,078.20 | ↓ -83% |
| AETNA | MANAGED MEDICAID | $1,108.15 | ↓ -83% |
| HORIZON | MANAGED MEDICAID | $1,188.00 | ↓ -82% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -82% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,227.95 | ↓ -81% |
| QUALCARE | HMO | $1,982.00 | ↓ -70% |
| CIGNA | HMO | $3,133.00 | ↓ -52% |
| CIGNA | PPO | $3,508.00 | ↓ -46% |
| HORIZON | PIP | $3,899.49 | ↓ -40% |
| HORIZON | WORKERS COMP | $4,024.68 | ↓ -38% |
| HORIZON | OMNIA | $4,325.38 | ↓ -34% |
| BERGEN RISK | ALL PRODUCTS | $4,492.50 | ↓ -31% |
| AETNA | ASA | $4,690.17 | ↓ -28% |
| CIGNA | BH | $4,792.00 | ↓ -26% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,091.50 | ↓ -22% |
| HORIZON | SHP | $5,141.82 | ↓ -21% |
| AMERIHEALTH | LOCAL HMO | $5,201.72 | ↓ -20% |
| HORIZON | INDEMNITY | $5,331.10 | ↓ -18% |
| HORIZON | HMO | $5,334.69 | ↓ -18% |
| QUALCARE | WORKERS COMP | $5,438.92 | ↓ -16% |
| QUALCARE | PPO | $5,438.92 | ↓ -16% |
| HORIZON | PPO | $5,476.06 | ↓ -16% |
| AMERIHEALTH | REGIONAL HMO | $5,891.76 | ↓ -9% |
| WELLCARE | MEDICARE ADVANTAGE | $6,505.71 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $6,505.71 | ↑ +0% |
| VACCN | ALL PRODUCTS | $6,505.71 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $6,505.71 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $6,830.99 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $7,091.22 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $7,806.85 | ↑ +20% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +27% |
| AETNA | PPO | $9,383.00 | ↑ +44% |
| AETNA | HMO | $9,383.00 | ↑ +44% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +53% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +57% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Egd w/transmural drain cyst at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $6,588.93 | $6,588.93 – $7,906.71 |
| Hackensack University Medical Center | Hackensack | $7,010.39 | $814.64 – $7,360.91 |
| Ocean University Medical Center | Brick | $6,505.71 | $791.46 – $7,806.85 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $6,594.64 | $420.00 – $6,594.64 |
| Jersey Shore University Medical Center | Neptune City | $6,588.93 | $791.46 – $7,906.71 |
| Palisades Medical Center | North Bergen | $7,010.39 | $413.70 – $7,641.32 |
| Raritan Bay Medical Center | Perth Amboy | $6,594.64 | $814.64 – $7,913.57 |
| Riverview Medical Center | Red Bank | $6,588.93 | $791.46 – $7,906.71 |