Open tx rib 1-3 fx w/fix 21811 at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$7,807.24
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.
$19,280.00
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.
$1,189.00 with UNITED HEALTHCARE vs $17,506.24 with QUALCARE — 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 |
|---|---|---|---|
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -85% |
| KARNA | MEDICARE ADVANTAGE | $1,208.77 | ↓ -85% |
| HORIZON | MANAGED MEDICAID | $1,679.00 | ↓ -78% |
| CLOVER | MEDICARE ADVANTAGE | $3,470.40 | ↓ -56% |
| AETNA | MANAGED MEDICAID | $3,566.80 | ↓ -54% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $3,952.40 | ↓ -49% |
| HORIZON | OMNIA | $7,049.00 | ↓ -10% |
| WELLCARE | MANAGED MEDICAID | $7,807.24 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $7,807.24 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $7,807.24 | ↑ +0% |
| VACCN | ALL PRODUCTS | $7,807.24 | ↑ +0% |
| HORIZON | SHP | $7,963.00 | ↑ +2% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $8,197.60 | ↑ +5% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +6% |
| AETNA | MEDICARE ADVANTAGE | $8,509.89 | ↑ +9% |
| HORIZON | INDEMNITY | $8,703.00 | ↑ +11% |
| HORIZON | HMO | $8,706.00 | ↑ +12% |
| HORIZON | PPO | $8,936.00 | ↑ +14% |
| UNITED HEALTHCARE | DSNP | $9,368.69 | ↑ +20% |
| AETNA | HMO | $9,383.00 | ↑ +20% |
| AETNA | PPO | $9,383.00 | ↑ +20% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +27% |
| QUALCARE | WORKERS COMP | $10,197.00 | ↑ +31% |
| QUALCARE | PPO | $10,197.00 | ↑ +31% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +31% |
| HORIZON | PIP | $12,551.28 | ↑ +61% |
| HORIZON | WORKERS COMP | $12,954.23 | ↑ +66% |
| AMERIHEALTH | LOCAL HMO | $13,972.00 | ↑ +79% |
| BERGEN RISK | ALL PRODUCTS | $14,460.00 | ↑ +85% |
| AETNA | ASA | $15,096.24 | ↑ +93% |
| CIGNA | BH | $15,424.00 | ↑ +98% |
| AMERIHEALTH | REGIONAL HMO | $15,795.00 | ↑ +102% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $16,388.00 | ↑ +110% |
| CIGNA | HMO | $17,330.79 | ↑ +122% |
| CIGNA | PPO | $17,330.79 | ↑ +122% |
| QUALCARE | HMO | $17,506.24 | ↑ +124% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Open tx rib 1-3 fx w/fix 21811 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $297.40 – $15,614.48 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $561.68 – $16,029.38 |
| Community Medical Center | Toms River | $3,786.00 | $575.21 – $15,536.41 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $554.91 – $15,949.23 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $306.15 – $16,029.38 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $384.87 – $16,741.65 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $1,109.82 – $15,735.15 |
| Bayshore Medical Center | Holmdel | $7,907.11 | $7,907.11 – $9,488.53 |