Ins pm gen w/exist mlt leads at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$20,842.49
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.
$23,143.00
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.
$727.22 with KARNA vs $63,824.00 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 | $727.22 | ↓ -97% |
| CLOVER | MEDICARE ADVANTAGE | $4,165.74 | ↓ -80% |
| AETNA | MANAGED MEDICAID | $4,281.46 | ↓ -79% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $4,744.32 | ↓ -77% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $13,631.23 | ↓ -35% |
| HORIZON | MANAGED MEDICAID | $14,668.03 | ↓ -30% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $14,811.52 | ↓ -29% |
| HORIZON | PIP | $15,066.09 | ↓ -28% |
| HORIZON | WORKERS COMP | $15,549.78 | ↓ -25% |
| HORIZON | OMNIA | $16,711.56 | ↓ -20% |
| BERGEN RISK | ALL PRODUCTS | $17,357.25 | ↓ -17% |
| AETNA | ASA | $18,120.97 | ↓ -13% |
| CIGNA | BH | $18,514.40 | ↓ -11% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $19,671.55 | ↓ -6% |
| HORIZON | SHP | $19,865.95 | ↓ -5% |
| AMERIHEALTH | LOCAL HMO | $20,097.38 | ↓ -4% |
| HORIZON | INDEMNITY | $20,597.27 | ↓ -1% |
| HORIZON | HMO | $20,611.16 | ↓ -1% |
| AETNA | HMO | $20,833.33 | ↓ -0% |
| AETNA | PPO | $20,833.33 | ↓ -0% |
| WELLCARE | MEDICARE ADVANTAGE | $20,842.49 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $20,842.49 | ↑ +0% |
| VACCN | ALL PRODUCTS | $20,842.49 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $20,842.49 | ↑ +0% |
| QUALCARE | WORKERS COMP | $21,013.84 | ↑ +1% |
| QUALCARE | HMO | $21,013.84 | ↑ +1% |
| QUALCARE | PPO | $21,013.84 | ↑ +1% |
| HORIZON | PPO | $21,157.33 | ↑ +2% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $21,884.61 | ↑ +5% |
| CIGNA | HMO | $22,131.65 | ↑ +6% |
| CIGNA | PPO | $22,131.65 | ↑ +6% |
| AETNA | MEDICARE ADVANTAGE | $22,718.31 | ↑ +9% |
| AMERIHEALTH | REGIONAL HMO | $22,763.45 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $25,010.99 | ↑ +20% |
| OXFORD | ALL PRODUCTS | $62,603.00 | ↑ +200% |
| UNITED HEALTHCARE | HMO | $63,824.00 | ↑ +206% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Ins pm gen w/exist mlt leads at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $178.93 – $41,684.98 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $251.59 – $42,792.64 |
| Community Medical Center | Toms River | $3,786.00 | $257.65 – $41,476.56 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $248.56 – $42,578.68 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $184.19 – $42,792.64 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $231.55 – $44,694.09 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $497.12 – $42,007.11 |
| Bayshore Medical Center | Holmdel | $21,109.10 | $21,109.10 – $25,330.93 |