Excision breast lesion at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$4,184.94
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.
?
What you pay up front if you don't use insurance.
$7,256.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$966.80 with KARNA vs $10,216.00 with UNITED HEALTHCARE — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $966.80 | ↓ -77% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -72% |
| CLOVER | MEDICARE ADVANTAGE | $1,306.08 | ↓ -69% |
| AETNA | MANAGED MEDICAID | $1,342.36 | ↓ -68% |
| HORIZON | MANAGED MEDICAID | $1,361.00 | ↓ -67% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,487.48 | ↓ -64% |
| AETNA | MEDICARE ADVANTAGE | $1,516.50 | ↓ -64% |
| QUALCARE | HMO | $2,255.00 | ↓ -46% |
| CIGNA | HMO | $3,586.00 | ↓ -14% |
| CIGNA | PPO | $4,011.00 | ↓ -4% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $4,184.94 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $4,184.94 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,184.94 | ↑ +0% |
| VACCN | ALL PRODUCTS | $4,184.94 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,394.19 | ↑ +5% |
| HORIZON | PIP | $4,723.66 | ↑ +13% |
| HORIZON | WORKERS COMP | $4,875.31 | ↑ +16% |
| UNITED HEALTHCARE | DSNP | $5,021.93 | ↑ +20% |
| HORIZON | OMNIA | $5,239.56 | ↑ +25% |
| BERGEN RISK | ALL PRODUCTS | $5,442.00 | ↑ +30% |
| AETNA | ASA | $5,681.45 | ↑ +36% |
| CIGNA | BH | $5,804.80 | ↑ +39% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $6,167.60 | ↑ +47% |
| HORIZON | SHP | $6,228.55 | ↑ +49% |
| AMERIHEALTH | LOCAL HMO | $6,301.11 | ↑ +51% |
| HORIZON | INDEMNITY | $6,457.84 | ↑ +54% |
| HORIZON | HMO | $6,462.19 | ↑ +54% |
| QUALCARE | PPO | $6,588.45 | ↑ +57% |
| QUALCARE | WORKERS COMP | $6,588.45 | ↑ +57% |
| HORIZON | PPO | $6,633.44 | ↑ +59% |
| AMERIHEALTH | REGIONAL HMO | $7,137.00 | ↑ +71% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +97% |
| AETNA | HMO | $9,383.00 | ↑ +124% |
| AETNA | PPO | $9,383.00 | ↑ +124% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +137% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +144% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Excision breast lesion at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $4,238.48 | $4,238.48 – $5,086.17 |
| Hackensack University Medical Center | Hackensack | $4,509.59 | $996.17 – $4,735.07 |
| Ocean University Medical Center | Brick | $4,184.94 | $966.80 – $5,829.14 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $4,242.15 | $313.32 – $5,829.14 |
| Jersey Shore University Medical Center | Neptune City | $4,238.48 | $966.80 – $5,086.17 |
| Palisades Medical Center | North Bergen | $4,509.59 | $308.62 – $4,915.45 |
| Raritan Bay Medical Center | Perth Amboy | $4,242.15 | $391.65 – $5,090.58 |
| Riverview Medical Center | Red Bank | $4,238.48 | $966.80 – $5,086.17 |