Remove tonsils and adenoids at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$6,465.11
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.
$9,176.00
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.
$612.28 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 | $612.28 | ↓ -91% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -82% |
| HORIZON | MANAGED MEDICAID | $1,361.00 | ↓ -79% |
| CLOVER | MEDICARE ADVANTAGE | $1,651.68 | ↓ -74% |
| AETNA | MANAGED MEDICAID | $1,697.56 | ↓ -74% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,881.08 | ↓ -71% |
| QUALCARE | HMO | $2,744.00 | ↓ -58% |
| CIGNA | HMO | $3,586.00 | ↓ -45% |
| CIGNA | PPO | $4,011.00 | ↓ -38% |
| HORIZON | PIP | $5,973.58 | ↓ -8% |
| HORIZON | WORKERS COMP | $6,165.35 | ↓ -5% |
| WELLCARE | MEDICARE ADVANTAGE | $6,465.11 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $6,465.11 | ↑ +0% |
| VACCN | ALL PRODUCTS | $6,465.11 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $6,465.11 | ↑ +0% |
| HORIZON | OMNIA | $6,625.99 | ↑ +2% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $6,788.36 | ↑ +5% |
| BERGEN RISK | ALL PRODUCTS | $6,882.00 | ↑ +6% |
| AETNA | MEDICARE ADVANTAGE | $7,046.97 | ↑ +9% |
| AETNA | ASA | $7,184.81 | ↑ +11% |
| CIGNA | BH | $7,340.80 | ↑ +14% |
| UNITED HEALTHCARE | DSNP | $7,758.13 | ↑ +20% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $7,799.60 | ↑ +21% |
| HORIZON | SHP | $7,876.68 | ↑ +22% |
| AMERIHEALTH | LOCAL HMO | $7,968.44 | ↑ +23% |
| HORIZON | INDEMNITY | $8,166.64 | ↑ +26% |
| HORIZON | HMO | $8,172.15 | ↑ +26% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +28% |
| QUALCARE | WORKERS COMP | $8,331.81 | ↑ +29% |
| QUALCARE | PPO | $8,331.81 | ↑ +29% |
| HORIZON | PPO | $8,388.70 | ↑ +30% |
| AMERIHEALTH | REGIONAL HMO | $9,025.51 | ↑ +40% |
| AETNA | HMO | $9,383.00 | ↑ +45% |
| AETNA | PPO | $9,383.00 | ↑ +45% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +54% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +58% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Remove tonsils and adenoids at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $150.64 – $12,930.22 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $196.71 – $13,273.80 |
| Community Medical Center | Toms River | $3,786.00 | $201.45 – $12,865.57 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $194.34 – $13,207.43 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $155.07 – $13,273.80 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $194.95 – $13,863.61 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $388.68 – $13,030.14 |
| Bayshore Medical Center | Holmdel | $6,547.81 | $6,547.81 – $7,857.37 |