Proctosigmoidoscopy tumor removal 45315 at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$1,288.59
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.
$2,550.00
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.
$218.03 with KARNA vs $9,933.00 with BRIGHTON HEALTH PLAN — 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 | $218.03 | ↓ -83% |
| CLOVER | MEDICARE ADVANTAGE | $459.00 | ↓ -64% |
| AETNA | MANAGED MEDICAID | $471.75 | ↓ -63% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $522.75 | ↓ -59% |
| HORIZON | MANAGED MEDICAID | $903.00 | ↓ -30% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -8% |
| WELLCARE | MEDICARE ADVANTAGE | $1,288.59 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $1,288.59 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,288.59 | ↑ +0% |
| VACCN | ALL PRODUCTS | $1,288.59 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,353.02 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $1,404.57 | ↑ +9% |
| QUALCARE | HMO | $1,525.00 | ↑ +18% |
| UNITED HEALTHCARE | DSNP | $1,546.31 | ↑ +20% |
| HORIZON | PIP | $1,660.05 | ↑ +29% |
| HORIZON | WORKERS COMP | $1,713.35 | ↑ +33% |
| HORIZON | OMNIA | $1,841.36 | ↑ +43% |
| BERGEN RISK | ALL PRODUCTS | $1,912.50 | ↑ +48% |
| AETNA | ASA | $1,996.65 | ↑ +55% |
| CIGNA | BH | $2,040.00 | ↑ +58% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $2,167.50 | ↑ +68% |
| HORIZON | SHP | $2,188.92 | ↑ +70% |
| AMERIHEALTH | LOCAL HMO | $2,214.42 | ↑ +72% |
| CIGNA | HMO | $2,249.00 | ↑ +75% |
| HORIZON | INDEMNITY | $2,269.50 | ↑ +76% |
| HORIZON | HMO | $2,271.03 | ↑ +76% |
| QUALCARE | PPO | $2,315.40 | ↑ +80% |
| QUALCARE | WORKERS COMP | $2,315.40 | ↑ +80% |
| HORIZON | PPO | $2,331.21 | ↑ +81% |
| AMERIHEALTH | REGIONAL HMO | $2,508.18 | ↑ +95% |
| CIGNA | PPO | $2,518.00 | ↑ +95% |
| OXFORD | ALL PRODUCTS | $6,189.00 | ↑ +380% |
| UNITED HEALTHCARE | HMO | $7,601.00 | ↑ +490% |
| AETNA | PPO | $9,383.00 | ↑ +628% |
| AETNA | HMO | $9,383.00 | ↑ +628% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +671% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Proctosigmoidoscopy tumor removal 45315 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $117.87 – $2,577.18 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $122.52 – $2,645.66 |
| Community Medical Center | Toms River | $3,786.00 | $125.48 – $2,564.29 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $121.05 – $2,632.43 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $121.34 – $2,645.66 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $132.86 – $2,763.23 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $242.10 – $2,597.11 |
| Bayshore Medical Center | Holmdel | $1,305.08 | $1,305.08 – $1,566.09 |