Repair leg fascia defect at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$3,545.97
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.
$6,635.00
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.
$719.33 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 | $719.33 | ↓ -80% |
| HORIZON | MANAGED MEDICAID | $1,188.00 | ↓ -66% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -66% |
| CLOVER | MEDICARE ADVANTAGE | $1,194.30 | ↓ -66% |
| AETNA | MANAGED MEDICAID | $1,227.48 | ↓ -65% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,360.18 | ↓ -62% |
| QUALCARE | HMO | $1,982.00 | ↓ -44% |
| CIGNA | HMO | $3,133.00 | ↓ -12% |
| CIGNA | PPO | $3,508.00 | ↓ -1% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,545.97 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,545.97 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,545.97 | ↑ +0% |
| VACCN | ALL PRODUCTS | $3,545.97 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,723.27 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $3,865.11 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $4,255.16 | ↑ +20% |
| HORIZON | PIP | $4,319.39 | ↑ +22% |
| HORIZON | WORKERS COMP | $4,458.06 | ↑ +26% |
| HORIZON | OMNIA | $4,791.13 | ↑ +35% |
| BERGEN RISK | ALL PRODUCTS | $4,976.25 | ↑ +40% |
| AETNA | ASA | $5,195.21 | ↑ +47% |
| CIGNA | BH | $5,308.00 | ↑ +50% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,639.75 | ↑ +59% |
| HORIZON | SHP | $5,695.48 | ↑ +61% |
| AMERIHEALTH | LOCAL HMO | $5,761.83 | ↑ +62% |
| HORIZON | INDEMNITY | $5,905.15 | ↑ +67% |
| HORIZON | HMO | $5,909.13 | ↑ +67% |
| QUALCARE | PPO | $6,024.58 | ↑ +70% |
| QUALCARE | WORKERS COMP | $6,024.58 | ↑ +70% |
| HORIZON | PPO | $6,065.72 | ↑ +71% |
| AMERIHEALTH | REGIONAL HMO | $6,526.19 | ↑ +84% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +133% |
| AETNA | HMO | $9,383.00 | ↑ +165% |
| AETNA | PPO | $9,383.00 | ↑ +165% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +180% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +188% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Repair leg fascia defect at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $274.01 – $7,091.94 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $343.47 – $7,280.38 |
| Community Medical Center | Toms River | $3,786.00 | $351.75 – $7,056.48 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $339.33 – $7,243.98 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $282.07 – $7,280.38 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $354.60 – $7,603.89 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $678.66 – $7,146.75 |
| Bayshore Medical Center | Holmdel | $3,591.33 | $3,591.33 – $4,309.59 |