Exploration maxillary sinus at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$4,029.39
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.
$7,698.00
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.
$369.09 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 | $369.09 | ↓ -91% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -70% |
| HORIZON | MANAGED MEDICAID | $1,361.00 | ↓ -66% |
| CLOVER | MEDICARE ADVANTAGE | $1,385.64 | ↓ -66% |
| AETNA | MANAGED MEDICAID | $1,424.13 | ↓ -65% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,578.09 | ↓ -61% |
| AETNA | MEDICARE ADVANTAGE | $1,608.88 | ↓ -60% |
| QUALCARE | HMO | $2,255.00 | ↓ -44% |
| CIGNA | HMO | $3,586.00 | ↓ -11% |
| CIGNA | PPO | $4,011.00 | ↓ -0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $4,029.39 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $4,029.39 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,029.39 | ↑ +0% |
| VACCN | ALL PRODUCTS | $4,029.39 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,230.86 | ↑ +5% |
| UNITED HEALTHCARE | DSNP | $4,835.27 | ↑ +20% |
| HORIZON | PIP | $5,011.40 | ↑ +24% |
| HORIZON | WORKERS COMP | $5,172.29 | ↑ +28% |
| HORIZON | OMNIA | $5,558.73 | ↑ +38% |
| BERGEN RISK | ALL PRODUCTS | $5,773.50 | ↑ +43% |
| AETNA | ASA | $6,027.53 | ↑ +50% |
| CIGNA | BH | $6,158.40 | ↑ +53% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $6,543.30 | ↑ +62% |
| HORIZON | SHP | $6,607.96 | ↑ +64% |
| AMERIHEALTH | LOCAL HMO | $6,684.94 | ↑ +66% |
| HORIZON | INDEMNITY | $6,851.22 | ↑ +70% |
| HORIZON | HMO | $6,855.84 | ↑ +70% |
| QUALCARE | WORKERS COMP | $6,989.78 | ↑ +73% |
| QUALCARE | PPO | $6,989.78 | ↑ +73% |
| HORIZON | PPO | $7,037.51 | ↑ +75% |
| AMERIHEALTH | REGIONAL HMO | $7,571.75 | ↑ +88% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +105% |
| AETNA | PPO | $9,383.00 | ↑ +133% |
| AETNA | HMO | $9,383.00 | ↑ +133% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +147% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +154% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Exploration maxillary sinus at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $4,080.94 | $4,080.94 – $4,897.13 |
| Hackensack University Medical Center | Hackensack | $4,341.97 | $380.19 – $4,559.07 |
| Ocean University Medical Center | Brick | $4,029.39 | $369.09 – $5,673.17 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $4,084.48 | $189.20 – $5,673.17 |
| Jersey Shore University Medical Center | Neptune City | $4,080.94 | $369.09 – $4,897.13 |
| Palisades Medical Center | North Bergen | $4,341.97 | $186.36 – $4,732.75 |
| Raritan Bay Medical Center | Perth Amboy | $4,084.48 | $236.50 – $6,795.04 |
| Riverview Medical Center | Red Bank | $4,080.94 | $369.09 – $4,897.13 |