Repair stomach opening at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$4,157.89
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.
$5,202.00
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.
$903.00 with HORIZON 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 |
|---|---|---|---|
| HORIZON | MANAGED MEDICAID | $903.00 | ↓ -78% |
| CLOVER | MEDICARE ADVANTAGE | $936.36 | ↓ -77% |
| AETNA | MANAGED MEDICAID | $962.37 | ↓ -77% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,066.41 | ↓ -74% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -71% |
| KARNA | MEDICARE ADVANTAGE | $1,468.18 | ↓ -65% |
| QUALCARE | HMO | $1,982.00 | ↓ -52% |
| CIGNA | HMO | $2,249.00 | ↓ -46% |
| CIGNA | PPO | $2,518.00 | ↓ -39% |
| HORIZON | PIP | $3,386.50 | ↓ -19% |
| HORIZON | WORKERS COMP | $3,495.22 | ↓ -16% |
| HORIZON | OMNIA | $3,756.36 | ↓ -10% |
| BERGEN RISK | ALL PRODUCTS | $3,901.50 | ↓ -6% |
| AETNA | ASA | $4,073.17 | ↓ -2% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $4,157.89 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,157.89 | ↑ +0% |
| VACCN | ALL PRODUCTS | $4,157.89 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $4,157.89 | ↑ +0% |
| CIGNA | BH | $4,161.60 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,365.79 | ↑ +5% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,421.70 | ↑ +6% |
| HORIZON | SHP | $4,465.40 | ↑ +7% |
| AMERIHEALTH | LOCAL HMO | $4,517.42 | ↑ +9% |
| AETNA | MEDICARE ADVANTAGE | $4,532.11 | ↑ +9% |
| HORIZON | INDEMNITY | $4,629.78 | ↑ +11% |
| HORIZON | HMO | $4,632.90 | ↑ +11% |
| QUALCARE | WORKERS COMP | $4,723.42 | ↑ +14% |
| QUALCARE | PPO | $4,723.42 | ↑ +14% |
| HORIZON | PPO | $4,755.67 | ↑ +14% |
| UNITED HEALTHCARE | DSNP | $4,989.47 | ↑ +20% |
| AMERIHEALTH | REGIONAL HMO | $5,116.69 | ↑ +23% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +98% |
| AETNA | PPO | $9,383.00 | ↑ +126% |
| AETNA | HMO | $9,383.00 | ↑ +126% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +139% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +146% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Repair stomach opening at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $361.22 – $8,315.78 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $420.00 – $8,536.76 |
| Community Medical Center | Toms River | $3,786.00 | $430.12 – $8,274.20 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $414.94 – $8,494.08 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $371.85 – $8,536.76 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $455.42 – $8,916.08 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $829.87 – $8,380.05 |
| Bayshore Medical Center | Holmdel | $4,211.08 | $4,211.08 – $5,053.30 |