Incision of iris at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$2,492.56
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.
$3,804.00
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.
$684.72 with CLOVER vs $9,933.00 with BRIGHTON HEALTH PLAN — 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 |
|---|---|---|---|
| CLOVER | MEDICARE ADVANTAGE | $684.72 | ↓ -73% |
| AETNA | MANAGED MEDICAID | $703.74 | ↓ -72% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $779.82 | ↓ -69% |
| KARNA | MEDICARE ADVANTAGE | $824.30 | ↓ -67% |
| HORIZON | MANAGED MEDICAID | $903.00 | ↓ -64% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -52% |
| QUALCARE | HMO | $1,525.00 | ↓ -39% |
| CIGNA | HMO | $2,249.00 | ↓ -10% |
| HORIZON | PIP | $2,476.40 | ↓ -1% |
| WELLCARE | MEDICARE ADVANTAGE | $2,492.56 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $2,492.56 | ↑ +0% |
| VACCN | ALL PRODUCTS | $2,492.56 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $2,492.56 | ↑ +0% |
| CIGNA | PPO | $2,518.00 | ↑ +1% |
| HORIZON | WORKERS COMP | $2,555.91 | ↑ +3% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $2,617.19 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $2,716.89 | ↑ +9% |
| HORIZON | OMNIA | $2,746.87 | ↑ +10% |
| OXFORD | ALL PRODUCTS | $2,837.00 | ↑ +14% |
| BERGEN RISK | ALL PRODUCTS | $2,853.00 | ↑ +14% |
| AETNA | ASA | $2,978.53 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $2,991.08 | ↑ +20% |
| CIGNA | BH | $3,043.20 | ↑ +22% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $3,233.40 | ↑ +30% |
| HORIZON | SHP | $3,265.35 | ↑ +31% |
| AMERIHEALTH | LOCAL HMO | $3,303.39 | ↑ +33% |
| UNITED HEALTHCARE | HMO | $3,352.00 | ↑ +34% |
| HORIZON | INDEMNITY | $3,385.56 | ↑ +36% |
| HORIZON | HMO | $3,387.84 | ↑ +36% |
| QUALCARE | WORKERS COMP | $3,454.03 | ↑ +39% |
| QUALCARE | PPO | $3,454.03 | ↑ +39% |
| HORIZON | PPO | $3,477.62 | ↑ +40% |
| AMERIHEALTH | REGIONAL HMO | $3,741.61 | ↑ +50% |
| AETNA | HMO | $9,383.00 | ↑ +276% |
| AETNA | PPO | $9,383.00 | ↑ +276% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +299% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Incision of iris at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $2,524.45 | $2,524.45 – $3,029.34 |
| Hackensack University Medical Center | Hackensack | $2,685.92 | $861.62 – $2,820.22 |
| Ocean University Medical Center | Brick | $2,492.56 | $824.30 – $2,991.08 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $2,526.64 | $288.02 – $2,526.64 |
| Jersey Shore University Medical Center | Neptune City | $2,524.45 | $824.30 – $3,029.34 |
| Palisades Medical Center | North Bergen | $2,685.92 | $861.62 – $2,927.66 |
| Raritan Bay Medical Center | Perth Amboy | $2,526.64 | $861.62 – $3,031.97 |
| Riverview Medical Center | Red Bank | $2,524.45 | $824.30 – $3,029.34 |