Ins/rpl pm w/tv ld atrl at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$11,437.35
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.
$15,648.00
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.
$923.05 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 | $923.05 | ↓ -92% |
| CLOVER | MEDICARE ADVANTAGE | $2,816.64 | ↓ -75% |
| AETNA | MANAGED MEDICAID | $2,894.88 | ↓ -75% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $3,207.84 | ↓ -72% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $9,216.67 | ↓ -19% |
| HORIZON | MANAGED MEDICAID | $9,917.70 | ↓ -13% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,014.72 | ↓ -12% |
| HORIZON | PIP | $10,186.85 | ↓ -11% |
| HORIZON | WORKERS COMP | $10,513.89 | ↓ -8% |
| HORIZON | OMNIA | $11,299.42 | ↓ -1% |
| WELLCARE | MEDICARE ADVANTAGE | $11,437.35 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $11,437.35 | ↑ +0% |
| VACCN | ALL PRODUCTS | $11,437.35 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $11,437.35 | ↑ +0% |
| BERGEN RISK | ALL PRODUCTS | $11,736.00 | ↑ +3% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $12,009.22 | ↑ +5% |
| AETNA | ASA | $12,252.38 | ↑ +7% |
| AETNA | MEDICARE ADVANTAGE | $12,466.71 | ↑ +9% |
| CIGNA | BH | $12,518.40 | ↑ +9% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $13,300.80 | ↑ +16% |
| HORIZON | SHP | $13,432.24 | ↑ +17% |
| AMERIHEALTH | LOCAL HMO | $13,588.72 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $13,724.82 | ↑ +20% |
| HORIZON | INDEMNITY | $13,926.72 | ↑ +22% |
| HORIZON | HMO | $13,936.11 | ↑ +22% |
| AETNA | HMO | $14,086.33 | ↑ +23% |
| AETNA | PPO | $14,086.33 | ↑ +23% |
| QUALCARE | PPO | $14,208.38 | ↑ +24% |
| QUALCARE | WORKERS COMP | $14,208.38 | ↑ +24% |
| QUALCARE | HMO | $14,208.38 | ↑ +24% |
| HORIZON | PPO | $14,305.40 | ↑ +25% |
| CIGNA | HMO | $14,964.18 | ↑ +31% |
| CIGNA | PPO | $14,964.18 | ↑ +31% |
| AMERIHEALTH | REGIONAL HMO | $15,391.37 | ↑ +35% |
| OXFORD | ALL PRODUCTS | $62,603.00 | ↑ +447% |
| UNITED HEALTHCARE | HMO | $63,824.00 | ↑ +458% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl pm w/tv ld atrl at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $227.10 – $22,874.70 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $680.60 – $23,482.52 |
| Community Medical Center | Toms River | $3,786.00 | $697.00 – $22,760.33 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $672.40 – $23,365.11 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $233.78 – $23,482.52 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $293.90 – $24,525.95 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $1,344.80 – $23,051.48 |
| Bayshore Medical Center | Holmdel | $11,583.66 | $11,583.66 – $13,900.39 |