ER Visit (level 5, high severity) at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$670.04
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.
$4,125.00
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.
$140.00 with AMERIGROUP vs $4,374.00 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 |
|---|---|---|---|
| AMERIGROUP | MANAGED MEDICAID | $140.00 | ↓ -79% |
| KARNA | MEDICARE ADVANTAGE | $284.08 | ↓ -58% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $358.00 | ↓ -47% |
| HORIZON | MANAGED MEDICAID | $462.00 | ↓ -31% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $670.04 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $670.04 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $670.04 | ↑ +0% |
| VACCN | ALL PRODUCTS | $670.04 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $703.55 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $730.35 | ↑ +9% |
| CLOVER | MEDICARE ADVANTAGE | $742.50 | ↑ +11% |
| AETNA | MANAGED MEDICAID | $763.13 | ↑ +14% |
| UNITED HEALTHCARE | DSNP | $804.05 | ↑ +20% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $845.63 | ↑ +26% |
| AMERIHEALTH | LOCAL HMO | $1,416.00 | ↑ +111% |
| BERGEN RISK | ALL PRODUCTS | $1,522.00 | ↑ +127% |
| AMERIHEALTH | REGIONAL HMO | $1,599.00 | ↑ +139% |
| HORIZON | OMNIA | $2,209.00 | ↑ +230% |
| HORIZON | SHP | $2,516.00 | ↑ +275% |
| HORIZON | PIP | $2,685.38 | ↑ +301% |
| HORIZON | HMO | $2,727.00 | ↑ +307% |
| HORIZON | WORKERS COMP | $2,771.59 | ↑ +314% |
| HORIZON | INDEMNITY | $2,932.00 | ↑ +338% |
| AETNA | ASA | $3,229.88 | ↑ +382% |
| CIGNA | BH | $3,300.00 | ↑ +393% |
| HORIZON | PPO | $3,373.00 | ↑ +403% |
| AETNA | HMO | $3,478.00 | ↑ +419% |
| AETNA | PPO | $3,478.00 | ↑ +419% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $3,506.25 | ↑ +423% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $3,539.00 | ↑ +428% |
| CIGNA | PPO | $3,707.96 | ↑ +453% |
| CIGNA | HMO | $3,707.96 | ↑ +453% |
| QUALCARE | WORKERS COMP | $3,745.50 | ↑ +459% |
| QUALCARE | HMO | $3,745.50 | ↑ +459% |
| QUALCARE | PPO | $3,745.50 | ↑ +459% |
| OXFORD | ALL PRODUCTS | $4,256.00 | ↑ +535% |
| UNITED HEALTHCARE | HMO | $4,374.00 | ↑ +553% |
Visitor-reported prices
Comments
ER Visit (level 5, high severity) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $678.62 | $678.62 – $1,787.00 |
| Hackensack University Medical Center | Hackensack | $722.02 | $290.51 – $1,944.00 |
| Ocean University Medical Center | Brick | $670.04 | $140.00 – $1,789.00 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $679.20 | $290.51 – $3,800.00 |
| Jersey Shore University Medical Center | Neptune City | $678.62 | $284.08 – $1,897.00 |
| Palisades Medical Center | North Bergen | $722.02 | $290.51 – $1,522.00 |
| Raritan Bay Medical Center | Perth Amboy | $679.20 | $140.00 – $1,699.00 |
| Riverview Medical Center | Red Bank | $678.62 | $140.00 – $1,836.00 |