Ins/rplc spi npg/rcvr pocket at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$33,303.98
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.
$34,689.00
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.
$709.07 with KARNA vs $39,964.77 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 | $709.07 | ↓ -98% |
| HORIZON | MANAGED MEDICAID | $1,188.00 | ↓ -96% |
| QUALCARE | HMO | $1,982.00 | ↓ -94% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $2,379.00 | ↓ -93% |
| CIGNA | HMO | $3,133.00 | ↓ -91% |
| CIGNA | PPO | $3,508.00 | ↓ -89% |
| CLOVER | MEDICARE ADVANTAGE | $6,244.02 | ↓ -81% |
| AETNA | MANAGED MEDICAID | $6,417.47 | ↓ -81% |
| HORIZON | OMNIA | $7,049.00 | ↓ -79% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $7,111.25 | ↓ -79% |
| HORIZON | SHP | $7,963.00 | ↓ -76% |
| HORIZON | INDEMNITY | $8,703.00 | ↓ -74% |
| HORIZON | HMO | $8,706.00 | ↓ -74% |
| HORIZON | PPO | $8,936.00 | ↓ -73% |
| AETNA | HMO | $9,383.00 | ↓ -72% |
| AETNA | PPO | $9,383.00 | ↓ -72% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↓ -70% |
| QUALCARE | WORKERS COMP | $10,197.00 | ↓ -69% |
| QUALCARE | PPO | $10,197.00 | ↓ -69% |
| AMERIHEALTH | LOCAL HMO | $13,972.00 | ↓ -58% |
| BERGEN RISK | ALL PRODUCTS | $15,603.00 | ↓ -53% |
| AMERIHEALTH | REGIONAL HMO | $15,795.00 | ↓ -53% |
| HORIZON | PIP | $22,582.54 | ↓ -32% |
| HORIZON | WORKERS COMP | $23,307.54 | ↓ -30% |
| AETNA | ASA | $27,161.49 | ↓ -18% |
| CIGNA | BH | $27,751.20 | ↓ -17% |
| OXFORD | ALL PRODUCTS | $28,880.00 | ↓ -13% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $29,485.65 | ↓ -11% |
| WELLCARE | MEDICARE ADVANTAGE | $33,303.98 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $33,303.98 | ↑ +0% |
| VACCN | ALL PRODUCTS | $33,303.98 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $33,303.98 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $34,969.18 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $36,301.33 | ↑ +9% |
| UNITED HEALTHCARE | HMO | $36,366.00 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $39,964.77 | ↑ +20% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rplc spi npg/rcvr pocket at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $174.46 – $66,607.96 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $333.68 – $68,377.86 |
| Community Medical Center | Toms River | $3,786.00 | $341.72 – $66,274.92 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $329.66 – $68,035.97 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $179.59 – $68,377.86 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $225.77 – $71,416.18 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $659.31 – $67,122.70 |
| Bayshore Medical Center | Holmdel | $33,730.00 | $33,730.00 – $40,476.00 |