Nipple exploration at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$4,184.94
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.
?
What you pay up front if you don't use insurance.
$6,625.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$742.05 with KARNA vs $10,216.00 with UNITED HEALTHCARE — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $742.05 | ↓ -82% |
| HORIZON | MANAGED MEDICAID | $1,188.00 | ↓ -72% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -72% |
| CLOVER | MEDICARE ADVANTAGE | $1,192.50 | ↓ -72% |
| AETNA | MANAGED MEDICAID | $1,225.63 | ↓ -71% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,358.13 | ↓ -68% |
| QUALCARE | HMO | $1,982.00 | ↓ -53% |
| CIGNA | HMO | $3,133.00 | ↓ -25% |
| CIGNA | PPO | $3,508.00 | ↓ -16% |
| WELLCARE | MEDICARE ADVANTAGE | $4,184.94 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $4,184.94 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,184.94 | ↑ +0% |
| VACCN | ALL PRODUCTS | $4,184.94 | ↑ +0% |
| HORIZON | PIP | $4,312.88 | ↑ +3% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,394.19 | ↑ +5% |
| HORIZON | WORKERS COMP | $4,451.34 | ↑ +6% |
| AETNA | MEDICARE ADVANTAGE | $4,561.59 | ↑ +9% |
| HORIZON | OMNIA | $4,783.91 | ↑ +14% |
| BERGEN RISK | ALL PRODUCTS | $4,968.75 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $5,021.93 | ↑ +20% |
| AETNA | ASA | $5,187.38 | ↑ +24% |
| CIGNA | BH | $5,300.00 | ↑ +27% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,631.25 | ↑ +35% |
| HORIZON | SHP | $5,686.90 | ↑ +36% |
| AMERIHEALTH | LOCAL HMO | $5,753.15 | ↑ +37% |
| HORIZON | INDEMNITY | $5,896.25 | ↑ +41% |
| HORIZON | HMO | $5,900.23 | ↑ +41% |
| QUALCARE | PPO | $6,015.50 | ↑ +44% |
| QUALCARE | WORKERS COMP | $6,015.50 | ↑ +44% |
| HORIZON | PPO | $6,056.58 | ↑ +45% |
| AMERIHEALTH | REGIONAL HMO | $6,516.35 | ↑ +56% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +97% |
| AETNA | PPO | $9,383.00 | ↑ +124% |
| AETNA | HMO | $9,383.00 | ↑ +124% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +137% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +144% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Nipple exploration at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $252.93 – $8,369.88 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $198.70 – $8,592.30 |
| Community Medical Center | Toms River | $3,786.00 | $203.49 – $8,328.03 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $196.31 – $8,549.34 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $260.37 – $8,592.30 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $215.46 – $8,974.08 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $392.62 – $8,434.58 |
| Bayshore Medical Center | Holmdel | $4,238.48 | $4,238.48 – $5,086.17 |