Removal of epididymis at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$3,769.31
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.
$9,728.00
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.
$1,174.48 with KARNA vs $10,216.00 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 | $1,174.48 | ↓ -69% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -68% |
| HORIZON | MANAGED MEDICAID | $1,679.00 | ↓ -55% |
| CLOVER | MEDICARE ADVANTAGE | $1,751.04 | ↓ -54% |
| AETNA | MANAGED MEDICAID | $1,799.68 | ↓ -52% |
| QUALCARE | HMO | $1,982.00 | ↓ -47% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,994.24 | ↓ -47% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,769.31 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,769.31 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,769.31 | ↑ +0% |
| VACCN | ALL PRODUCTS | $3,769.31 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,957.78 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $4,108.55 | ↑ +9% |
| CIGNA | HMO | $4,412.00 | ↑ +17% |
| UNITED HEALTHCARE | DSNP | $4,523.17 | ↑ +20% |
| CIGNA | PPO | $4,941.00 | ↑ +31% |
| HORIZON | PIP | $6,332.93 | ↑ +68% |
| HORIZON | WORKERS COMP | $6,536.24 | ↑ +73% |
| HORIZON | OMNIA | $7,024.59 | ↑ +86% |
| BERGEN RISK | ALL PRODUCTS | $7,296.00 | ↑ +94% |
| AETNA | ASA | $7,617.02 | ↑ +102% |
| CIGNA | BH | $7,782.40 | ↑ +106% |
| HORIZON | SHP | $7,963.00 | ↑ +111% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +119% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $8,268.80 | ↑ +119% |
| AMERIHEALTH | LOCAL HMO | $8,447.80 | ↑ +124% |
| HORIZON | INDEMNITY | $8,657.92 | ↑ +130% |
| HORIZON | HMO | $8,663.76 | ↑ +130% |
| QUALCARE | PPO | $8,833.02 | ↑ +134% |
| QUALCARE | WORKERS COMP | $8,833.02 | ↑ +134% |
| HORIZON | PPO | $8,893.34 | ↑ +136% |
| AETNA | PPO | $9,383.00 | ↑ +149% |
| AETNA | HMO | $9,383.00 | ↑ +149% |
| AMERIHEALTH | REGIONAL HMO | $9,568.46 | ↑ +154% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +164% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +171% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Removal of epididymis at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $288.97 – $7,538.62 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $365.57 – $7,738.94 |
| Community Medical Center | Toms River | $3,786.00 | $374.37 – $7,500.93 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $361.16 – $7,700.25 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $297.47 – $7,738.94 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $373.96 – $8,082.80 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $722.32 – $7,596.88 |
| Bayshore Medical Center | Holmdel | $3,817.53 | $3,817.53 – $4,581.03 |