Quant diff pulm perf and vent w/imaging at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$588.26
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.
$2,649.00
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.
$476.82 with CLOVER vs $2,421.72 with HORIZON — 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 | $476.82 | ↓ -19% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $490.01 | ↓ -17% |
| AETNA | MANAGED MEDICAID | $490.07 | ↓ -17% |
| KARNA | MEDICARE ADVANTAGE | $509.06 | ↓ -13% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $543.05 | ↓ -8% |
| VACCN | ALL PRODUCTS | $588.26 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $588.26 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $588.26 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $588.26 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $617.68 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $641.21 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $705.92 | ↑ +20% |
| AETNA | PPO | $859.58 | ↑ +46% |
| AETNA | HMO | $859.58 | ↑ +46% |
| CIGNA | PPO | $959.94 | ↑ +63% |
| CIGNA | HMO | $959.94 | ↑ +63% |
| AMERIHEALTH | LOCAL HMO | $1,017.42 | ↑ +73% |
| AMERIHEALTH | REGIONAL HMO | $1,035.02 | ↑ +76% |
| UNITED HEALTHCARE | HMO | $1,325.05 | ↑ +125% |
| OXFORD | ALL PRODUCTS | $1,433.11 | ↑ +144% |
| HORIZON | PIP | $1,724.50 | ↑ +193% |
| HORIZON | WORKERS COMP | $1,779.86 | ↑ +203% |
| HORIZON | OMNIA | $1,912.84 | ↑ +225% |
| BERGEN RISK | ALL PRODUCTS | $1,986.75 | ↑ +238% |
| AETNA | ASA | $2,074.17 | ↑ +253% |
| CIGNA | BH | $2,119.20 | ↑ +260% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $2,251.65 | ↑ +283% |
| HORIZON | SHP | $2,273.90 | ↑ +287% |
| HORIZON | INDEMNITY | $2,357.61 | ↑ +301% |
| HORIZON | HMO | $2,359.20 | ↑ +301% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $2,384.10 | ↑ +305% |
| QUALCARE | PPO | $2,405.29 | ↑ +309% |
| QUALCARE | HMO | $2,405.29 | ↑ +309% |
| QUALCARE | WORKERS COMP | $2,405.29 | ↑ +309% |
| HORIZON | PPO | $2,421.72 | ↑ +312% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| HORIZON | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Quant diff pulm perf and vent w/imaging at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $505.66 | $144.02 – $1,235.64 |
| Cooperman Barnabas Medical Center | Livingston | $536.95 | $221.15 – $1,235.64 |
| Community Medical Center | Toms River | $558.73 | $221.15 – $1,235.64 |
| Clara Maass Medical Center | Belleville | $267.32 | $221.15 – $1,235.64 |
| Newark Beth Israel Medical Center | Newark | $527.83 | $148.26 – $1,235.64 |
| Jersey City Medical Center | Jersey City | $559.81 | $186.38 – $1,261.46 |
| Monmouth Medical Center | Long Branch | $589.44 | $221.15 – $1,235.64 |
| Bayshore Medical Center | Holmdel | $595.79 | $490.01 – $1,325.05 |