Repair of eye socket wound at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$4,121.25
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.
$6,887.00
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.
$1,009.49 with KARNA vs $14,007.00 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 | $1,009.49 | ↓ -76% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -71% |
| CLOVER | MEDICARE ADVANTAGE | $1,239.66 | ↓ -70% |
| AETNA | MANAGED MEDICAID | $1,274.10 | ↓ -69% |
| HORIZON | MANAGED MEDICAID | $1,361.00 | ↓ -67% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,411.84 | ↓ -66% |
| QUALCARE | HMO | $2,255.00 | ↓ -45% |
| CIGNA | HMO | $3,586.00 | ↓ -13% |
| CIGNA | PPO | $4,011.00 | ↓ -3% |
| WELLCARE | MEDICARE ADVANTAGE | $4,121.25 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,121.25 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $4,121.25 | ↑ +0% |
| VACCN | ALL PRODUCTS | $4,121.25 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,327.31 | ↑ +5% |
| HORIZON | PIP | $4,483.44 | ↑ +9% |
| AETNA | MEDICARE ADVANTAGE | $4,492.16 | ↑ +9% |
| HORIZON | WORKERS COMP | $4,627.38 | ↑ +12% |
| UNITED HEALTHCARE | DSNP | $4,945.50 | ↑ +20% |
| HORIZON | OMNIA | $4,973.10 | ↑ +21% |
| BERGEN RISK | ALL PRODUCTS | $5,165.25 | ↑ +25% |
| AETNA | ASA | $5,392.52 | ↑ +31% |
| CIGNA | BH | $5,509.60 | ↑ +34% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,853.95 | ↑ +42% |
| HORIZON | SHP | $5,911.80 | ↑ +43% |
| AMERIHEALTH | LOCAL HMO | $5,980.67 | ↑ +45% |
| HORIZON | INDEMNITY | $6,129.43 | ↑ +49% |
| HORIZON | HMO | $6,133.56 | ↑ +49% |
| QUALCARE | PPO | $6,253.40 | ↑ +52% |
| QUALCARE | WORKERS COMP | $6,253.40 | ↑ +52% |
| HORIZON | PPO | $6,296.10 | ↑ +53% |
| AMERIHEALTH | REGIONAL HMO | $6,774.05 | ↑ +64% |
| AETNA | HMO | $9,383.00 | ↑ +128% |
| AETNA | PPO | $9,383.00 | ↑ +128% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +141% |
| OXFORD | ALL PRODUCTS | $11,243.00 | ↑ +173% |
| UNITED HEALTHCARE | HMO | $14,007.00 | ↑ +240% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Repair of eye socket wound at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $248.37 – $8,242.50 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $209.16 – $8,461.52 |
| Community Medical Center | Toms River | $3,786.00 | $214.20 – $8,201.29 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $206.64 – $8,419.21 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $255.68 – $8,461.52 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $226.80 – $8,837.51 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $413.28 – $8,306.20 |
| Bayshore Medical Center | Holmdel | $4,173.97 | $4,173.97 – $5,008.76 |