Pt evaluation high complexity patient/family at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$126.19
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.
$611.00
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 $600.98 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 | ↓ -52% |
| CLOVER | MEDICARE ADVANTAGE | $109.98 | ↓ -13% |
| AETNA | MANAGED MEDICAID | $113.04 | ↓ -10% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $125.26 | ↓ -1% |
| VACCN | ALL PRODUCTS | $126.19 | ↑ +0% |
| AMERIGROUP | MANAGED MEDICAID | $126.19 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $132.50 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $137.55 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $151.43 | ↑ +20% |
| QUALCARE | HMO | $160.00 | ↑ +27% |
| KARNA | MEDICARE ADVANTAGE | $166.07 | ↑ +32% |
| WELLCARE | MANAGED MEDICAID | $224.00 | ↑ +78% |
| WELLCARE | MEDICARE ADVANTAGE | $224.00 | ↑ +78% |
| QUALCARE | WORKERS COMP | $257.00 | ↑ +104% |
| QUALCARE | PPO | $257.00 | ↑ +104% |
| BERGEN RISK | ALL PRODUCTS | $349.00 | ↑ +177% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $359.88 | ↑ +185% |
| HORIZON | PIP | $397.76 | ↑ +215% |
| UNITED HEALTHCARE | HMO | $407.00 | ↑ +223% |
| HORIZON | WORKERS COMP | $410.53 | ↑ +225% |
| HORIZON | OMNIA | $441.20 | ↑ +250% |
| AETNA | ASA | $478.41 | ↑ +279% |
| CIGNA | BH | $488.80 | ↑ +287% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $517.00 | ↑ +310% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $519.35 | ↑ +312% |
| HORIZON | SHP | $524.48 | ↑ +316% |
| AMERIHEALTH | LOCAL HMO | $530.59 | ↑ +320% |
| HORIZON | INDEMNITY | $543.79 | ↑ +331% |
| HORIZON | HMO | $544.16 | ↑ +331% |
| HORIZON | PPO | $558.58 | ↑ +343% |
| OXFORD | ALL PRODUCTS | $563.00 | ↑ +346% |
| AETNA | PPO | $564.56 | ↑ +347% |
| AETNA | HMO | $564.56 | ↑ +347% |
| CIGNA | HMO | $584.30 | ↑ +363% |
| CIGNA | PPO | $584.30 | ↑ +363% |
| AMERIHEALTH | REGIONAL HMO | $600.98 | ↑ +376% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Pt evaluation high complexity patient/family at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Carrier Clinic | Belle Mead | $244.40 | $88.60 – $88.60 |
| Saint Barnabas Behavioral Health Center | Toms River | $76.26 | not published |
| Childrens Specialized Hospital | Mountainside | $354.50 | $237.00 – $394.00 |
| Bayshore Medical Center | Holmdel | $126.19 | $126.19 – $517.00 |
| Hackensack University Medical Center | Hackensack | $126.19 | $54.05 – $406.00 |
| Ocean University Medical Center | Brick | $126.19 | $60.00 – $517.00 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $126.19 | $60.00 – $523.00 |
| Jersey Shore University Medical Center | Neptune City | $126.19 | $80.00 – $561.00 |