Oth resp proc, indiv at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$26.76
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.
$182.00
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.
$18.64 with KARNA vs $655.00 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 | $18.64 | ↓ -30% |
| WELLCARE | MEDICARE ADVANTAGE | $26.76 | ↑ +0% |
| VACCN | ALL PRODUCTS | $26.76 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $26.76 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $26.76 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $28.10 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $29.17 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $32.12 | ↑ +20% |
| CLOVER | MEDICARE ADVANTAGE | $32.76 | ↑ +22% |
| AETNA | MANAGED MEDICAID | $33.67 | ↑ +26% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $37.31 | ↑ +39% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $107.20 | ↑ +301% |
| HORIZON | MANAGED MEDICAID | $115.35 | ↑ +331% |
| HORIZON | PIP | $118.48 | ↑ +343% |
| HORIZON | WORKERS COMP | $122.29 | ↑ +357% |
| HORIZON | OMNIA | $131.42 | ↑ +391% |
| BERGEN RISK | ALL PRODUCTS | $136.50 | ↑ +410% |
| AETNA | ASA | $142.51 | ↑ +433% |
| CIGNA | BH | $145.60 | ↑ +444% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $154.70 | ↑ +478% |
| HORIZON | SHP | $156.23 | ↑ +484% |
| AMERIHEALTH | LOCAL HMO | $158.05 | ↑ +491% |
| HORIZON | INDEMNITY | $161.98 | ↑ +505% |
| HORIZON | HMO | $162.09 | ↑ +506% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $163.80 | ↑ +512% |
| AETNA | HMO | $163.84 | ↑ +512% |
| AETNA | PPO | $163.84 | ↑ +512% |
| QUALCARE | PPO | $165.26 | ↑ +518% |
| QUALCARE | WORKERS COMP | $165.26 | ↑ +518% |
| QUALCARE | HMO | $165.26 | ↑ +518% |
| HORIZON | PPO | $166.38 | ↑ +522% |
| CIGNA | HMO | $174.05 | ↑ +550% |
| CIGNA | PPO | $174.05 | ↑ +550% |
| AMERIHEALTH | REGIONAL HMO | $179.02 | ↑ +569% |
| OXFORD | ALL PRODUCTS | $525.00 | ↑ +1862% |
| UNITED HEALTHCARE | HMO | $655.00 | ↑ +2348% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Oth resp proc, indiv at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Cooperman Barnabas Medical Center | Livingston | $47.46 | $27.48 – $54.96 |
| Clara Maass Medical Center | Belleville | $20.48 | $27.48 – $54.69 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $27.13 | $16.44 – $342.00 |
| Jersey Shore University Medical Center | Neptune City | $27.11 | $18.64 – $604.00 |
| Palisades Medical Center | North Bergen | $28.84 | $16.19 – $444.00 |
| Raritan Bay Medical Center | Perth Amboy | $27.13 | $19.70 – $396.00 |
| Riverview Medical Center | Red Bank | $27.11 | $18.64 – $271.00 |
| Robert Wood Johnson University Hospital Hamilton | Hamilton Township | $16.88 | $26.76 – $53.25 |