Partial proctectomy; perineal 45123 at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
not published by hospital
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.
$3,411.00
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.
$613.98 with CLOVER vs $23,291.00 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 |
|---|---|---|---|
| CLOVER | MEDICARE ADVANTAGE | $613.98 | — |
| AETNA | MANAGED MEDICAID | $631.04 | — |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $699.26 | — |
| AETNA | MEDICARE ADVANTAGE | $712.90 | — |
| QUALCARE | HMO | $1,525.00 | — |
| HORIZON | MANAGED MEDICAID | $1,679.00 | — |
| HORIZON | PIP | $2,220.56 | — |
| KARNA | MEDICARE ADVANTAGE | $2,283.68 | — |
| HORIZON | WORKERS COMP | $2,291.85 | — |
| UNITED HEALTHCARE | MANAGED MEDICAID | $2,379.00 | — |
| HORIZON | OMNIA | $2,463.08 | — |
| BERGEN RISK | ALL PRODUCTS | $2,558.25 | — |
| AETNA | ASA | $2,670.81 | — |
| CIGNA | BH | $2,728.80 | — |
| MULTIPLAN - PHCS | ALL PRODUCTS | $2,899.35 | — |
| HORIZON | SHP | $2,928.00 | — |
| AMERIHEALTH | LOCAL HMO | $2,962.11 | — |
| HORIZON | INDEMNITY | $3,035.79 | — |
| HORIZON | HMO | $3,037.84 | — |
| CIGNA | HMO | $3,066.15 | — |
| CIGNA | PPO | $3,066.15 | — |
| QUALCARE | PPO | $3,097.19 | — |
| QUALCARE | WORKERS COMP | $3,097.19 | — |
| HORIZON | PPO | $3,118.34 | — |
| AMERIHEALTH | REGIONAL HMO | $3,355.06 | — |
| AETNA | PPO | $9,383.00 | — |
| AETNA | HMO | $9,383.00 | — |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | — |
| OXFORD | ALL PRODUCTS | $18,565.00 | — |
| UNITED HEALTHCARE | HMO | $23,291.00 | — |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | not published by hospital | — |
| UNITED HEALTHCARE | DSNP | not published by hospital | — |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | not published by hospital | — |
| VACCN | ALL PRODUCTS | not published by hospital | — |
| WELLCARE | MANAGED MEDICAID | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| WELLCARE | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Partial proctectomy; perineal 45123 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | not published | $561.86 – $3,651.96 |
| Cooperman Barnabas Medical Center | Livingston | not published | $688.40 – $688.40 |
| Community Medical Center | Toms River | not published | $704.99 – $704.99 |
| Clara Maass Medical Center | Belleville | not published | $680.11 – $680.11 |
| Newark Beth Israel Medical Center | Newark | not published | $578.38 – $1,248.25 |
| Jersey City Medical Center | Jersey City | not published | $727.11 – $746.46 |
| Monmouth Medical Center | Long Branch | not published | $1,360.22 – $1,360.22 |
| Bayshore Medical Center | Holmdel | not published | not published |