Incision of knee joint at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$3,545.97
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.
$8,285.00
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.
$1,189.00 with UNITED HEALTHCARE vs $14,007.00 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 |
|---|---|---|---|
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -66% |
| CLOVER | MEDICARE ADVANTAGE | $1,491.30 | ↓ -58% |
| AETNA | MANAGED MEDICAID | $1,532.73 | ↓ -57% |
| HORIZON | MANAGED MEDICAID | $1,679.00 | ↓ -53% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,698.43 | ↓ -52% |
| KARNA | MEDICARE ADVANTAGE | $1,699.94 | ↓ -52% |
| QUALCARE | HMO | $2,744.00 | ↓ -23% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,545.97 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,545.97 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,545.97 | ↑ +0% |
| VACCN | ALL PRODUCTS | $3,545.97 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,723.27 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $3,865.11 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $4,255.16 | ↑ +20% |
| CIGNA | HMO | $4,412.00 | ↑ +24% |
| CIGNA | PPO | $4,941.00 | ↑ +39% |
| HORIZON | PIP | $5,393.54 | ↑ +52% |
| HORIZON | WORKERS COMP | $5,566.69 | ↑ +57% |
| HORIZON | OMNIA | $5,982.60 | ↑ +69% |
| BERGEN RISK | ALL PRODUCTS | $6,213.75 | ↑ +75% |
| AETNA | ASA | $6,487.16 | ↑ +83% |
| CIGNA | BH | $6,628.00 | ↑ +87% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $7,042.25 | ↑ +99% |
| HORIZON | SHP | $7,111.84 | ↑ +101% |
| AMERIHEALTH | LOCAL HMO | $7,194.69 | ↑ +103% |
| HORIZON | INDEMNITY | $7,373.65 | ↑ +108% |
| HORIZON | HMO | $7,378.62 | ↑ +108% |
| QUALCARE | PPO | $7,522.78 | ↑ +112% |
| QUALCARE | WORKERS COMP | $7,522.78 | ↑ +112% |
| HORIZON | PPO | $7,574.15 | ↑ +114% |
| AMERIHEALTH | REGIONAL HMO | $8,149.13 | ↑ +130% |
| AETNA | HMO | $9,383.00 | ↑ +165% |
| AETNA | PPO | $9,383.00 | ↑ +165% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +180% |
| OXFORD | ALL PRODUCTS | $11,243.00 | ↑ +217% |
| UNITED HEALTHCARE | HMO | $14,007.00 | ↑ +295% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Incision of knee joint at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $542.12 – $7,280.38 |
| Community Medical Center | Toms River | $3,786.00 | $555.19 – $7,056.48 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $535.59 – $7,243.98 |
| Bayshore Medical Center | Holmdel | $3,591.33 | $3,591.33 – $4,309.59 |
| Hackensack University Medical Center | Hackensack | $3,821.05 | $1,758.83 – $4,012.10 |
| Ocean University Medical Center | Brick | $3,545.97 | $1,699.94 – $4,255.16 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $3,594.44 | $653.16 – $3,594.44 |
| Jersey Shore University Medical Center | Neptune City | $3,591.33 | $1,699.94 – $4,309.59 |