Ins/rpl ldless pm right vent w img & eval 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.
$37,400.00
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.
$967.73 with KARNA vs $36,786.64 with AMERIHEALTH — 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 | $967.73 | ↓ -95% |
| CLOVER | MEDICARE ADVANTAGE | $6,732.00 | ↓ -68% |
| AETNA | MANAGED MEDICAID | $6,919.00 | ↓ -67% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $7,667.00 | ↓ -63% |
| WELLCARE | MANAGED MEDICAID | $20,842.49 | ↑ +0% |
| VACCN | ALL PRODUCTS | $20,842.49 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $20,842.49 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $20,842.49 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $21,884.61 | ↑ +5% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $22,028.60 | ↑ +6% |
| AETNA | MEDICARE ADVANTAGE | $22,718.31 | ↑ +9% |
| HORIZON | MANAGED MEDICAID | $23,704.12 | ↑ +14% |
| HORIZON | PIP | $24,347.40 | ↑ +17% |
| UNITED HEALTHCARE | DSNP | $25,010.99 | ↑ +20% |
| HORIZON | WORKERS COMP | $25,129.06 | ↑ +21% |
| OXFORD | ALL PRODUCTS | $26,587.66 | ↑ +28% |
| HORIZON | OMNIA | $27,006.54 | ↑ +30% |
| BERGEN RISK | ALL PRODUCTS | $28,050.00 | ↑ +35% |
| UNITED HEALTHCARE | HMO | $29,052.32 | ↑ +39% |
| AETNA | ASA | $29,284.20 | ↑ +41% |
| CIGNA | BH | $29,920.00 | ↑ +44% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $31,790.00 | ↑ +53% |
| HORIZON | SHP | $32,104.16 | ↑ +54% |
| AMERIHEALTH | LOCAL HMO | $32,478.16 | ↑ +56% |
| HORIZON | INDEMNITY | $33,286.00 | ↑ +60% |
| HORIZON | HMO | $33,308.44 | ↑ +60% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $33,660.00 | ↑ +61% |
| AETNA | HMO | $33,667.48 | ↑ +62% |
| AETNA | PPO | $33,667.48 | ↑ +62% |
| QUALCARE | PPO | $33,959.20 | ↑ +63% |
| QUALCARE | HMO | $33,959.20 | ↑ +63% |
| QUALCARE | WORKERS COMP | $33,959.20 | ↑ +63% |
| HORIZON | PPO | $34,191.08 | ↑ +64% |
| CIGNA | HMO | $35,765.62 | ↑ +72% |
| CIGNA | PPO | $35,765.62 | ↑ +72% |
| AMERIHEALTH | REGIONAL HMO | $36,786.64 | ↑ +76% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl ldless pm right vent w img & eval at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $238.10 – $41,684.98 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $456.04 – $42,792.64 |
| Community Medical Center | Toms River | $3,786.00 | $467.02 – $41,476.56 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $450.54 – $42,578.68 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $245.10 – $42,792.64 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $308.13 – $44,694.09 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $901.08 – $42,007.11 |
| Bayshore Medical Center | Holmdel | $21,109.10 | $21,109.10 – $25,330.93 |