Ot evaluation high complexity patient/family at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$128.99
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.
$583.00
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.
$60.00 with HORIZON vs $573.44 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 |
|---|---|---|---|
| HORIZON | MANAGED MEDICAID | $60.00 | ↓ -53% |
| CLOVER | MEDICARE ADVANTAGE | $104.94 | ↓ -19% |
| AETNA | MANAGED MEDICAID | $107.86 | ↓ -16% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $119.52 | ↓ -7% |
| VACCN | ALL PRODUCTS | $128.99 | ↑ +0% |
| AMERIGROUP | MANAGED MEDICAID | $128.99 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $135.44 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $140.60 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $154.79 | ↑ +20% |
| QUALCARE | HMO | $160.00 | ↑ +24% |
| KARNA | MEDICARE ADVANTAGE | $167.77 | ↑ +30% |
| WELLCARE | MANAGED MEDICAID | $224.00 | ↑ +74% |
| WELLCARE | MEDICARE ADVANTAGE | $224.00 | ↑ +74% |
| QUALCARE | WORKERS COMP | $257.00 | ↑ +99% |
| QUALCARE | PPO | $257.00 | ↑ +99% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $343.39 | ↑ +166% |
| BERGEN RISK | ALL PRODUCTS | $366.00 | ↑ +184% |
| HORIZON | PIP | $379.53 | ↑ +194% |
| HORIZON | WORKERS COMP | $391.72 | ↑ +204% |
| UNITED HEALTHCARE | HMO | $409.00 | ↑ +217% |
| HORIZON | OMNIA | $420.98 | ↑ +226% |
| AETNA | ASA | $456.49 | ↑ +254% |
| CIGNA | BH | $466.40 | ↑ +262% |
| OXFORD | ALL PRODUCTS | $488.00 | ↑ +278% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $495.55 | ↑ +284% |
| HORIZON | SHP | $500.45 | ↑ +288% |
| AMERIHEALTH | LOCAL HMO | $506.28 | ↑ +292% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $517.00 | ↑ +301% |
| HORIZON | INDEMNITY | $518.87 | ↑ +302% |
| HORIZON | HMO | $519.22 | ↑ +303% |
| HORIZON | PPO | $532.98 | ↑ +313% |
| AETNA | PPO | $538.69 | ↑ +318% |
| AETNA | HMO | $538.69 | ↑ +318% |
| CIGNA | PPO | $557.52 | ↑ +332% |
| CIGNA | HMO | $557.52 | ↑ +332% |
| AMERIHEALTH | REGIONAL HMO | $573.44 | ↑ +345% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Ot evaluation high complexity patient/family at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $120.69 | $51.75 – $170.00 |
| Childrens Specialized Hospital | Mountainside | $412.50 | $237.00 – $394.00 |
| Bayshore Medical Center | Holmdel | $128.99 | $128.99 – $749.00 |
| Hackensack University Medical Center | Hackensack | $128.99 | $54.05 – $406.00 |
| Ocean University Medical Center | Brick | $128.99 | $60.00 – $517.00 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $128.99 | $60.00 – $523.00 |
| Jersey Shore University Medical Center | Neptune City | $128.99 | $103.19 – $517.00 |
| Palisades Medical Center | North Bergen | $128.99 | $118.00 – $612.00 |