Excision of rectal lesion at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$2,997.10
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.
$6,766.00
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.
$1,188.00 with HORIZON 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 |
|---|---|---|---|
| HORIZON | MANAGED MEDICAID | $1,188.00 | ↓ -60% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -60% |
| CLOVER | MEDICARE ADVANTAGE | $1,217.88 | ↓ -59% |
| AETNA | MANAGED MEDICAID | $1,251.71 | ↓ -58% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,387.03 | ↓ -54% |
| QUALCARE | HMO | $1,982.00 | ↓ -34% |
| KARNA | MEDICARE ADVANTAGE | $2,126.30 | ↓ -29% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $2,997.10 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $2,997.10 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $2,997.10 | ↑ +0% |
| VACCN | ALL PRODUCTS | $2,997.10 | ↑ +0% |
| CIGNA | HMO | $3,133.00 | ↑ +5% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,146.96 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $3,266.84 | ↑ +9% |
| CIGNA | PPO | $3,508.00 | ↑ +17% |
| UNITED HEALTHCARE | DSNP | $3,596.52 | ↑ +20% |
| HORIZON | PIP | $4,404.67 | ↑ +47% |
| HORIZON | WORKERS COMP | $4,546.08 | ↑ +52% |
| HORIZON | OMNIA | $4,885.73 | ↑ +63% |
| BERGEN RISK | ALL PRODUCTS | $5,074.50 | ↑ +69% |
| AETNA | ASA | $5,297.78 | ↑ +77% |
| CIGNA | BH | $5,412.80 | ↑ +81% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,751.10 | ↑ +92% |
| HORIZON | SHP | $5,807.93 | ↑ +94% |
| AMERIHEALTH | LOCAL HMO | $5,875.59 | ↑ +96% |
| HORIZON | INDEMNITY | $6,021.74 | ↑ +101% |
| HORIZON | HMO | $6,025.80 | ↑ +101% |
| QUALCARE | PPO | $6,143.53 | ↑ +105% |
| QUALCARE | WORKERS COMP | $6,143.53 | ↑ +105% |
| HORIZON | PPO | $6,185.48 | ↑ +106% |
| AMERIHEALTH | REGIONAL HMO | $6,655.04 | ↑ +122% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +175% |
| AETNA | HMO | $9,383.00 | ↑ +213% |
| AETNA | PPO | $9,383.00 | ↑ +213% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +231% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +241% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Excision of rectal lesion at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $3,035.44 | $3,035.44 – $3,642.53 |
| Hackensack University Medical Center | Hackensack | $3,229.60 | $2,183.65 – $3,391.08 |
| Ocean University Medical Center | Brick | $2,997.10 | $2,126.30 – $3,596.52 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $3,038.07 | $612.26 – $3,038.07 |
| Jersey Shore University Medical Center | Neptune City | $3,035.44 | $2,126.30 – $3,642.53 |
| Palisades Medical Center | North Bergen | $3,229.60 | $2,183.65 – $3,520.27 |
| Raritan Bay Medical Center | Perth Amboy | $3,038.07 | $2,183.65 – $3,645.69 |
| Riverview Medical Center | Red Bank | $3,035.44 | $2,126.30 – $3,642.53 |