Resect thigh/knee tum 5 cm/> at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$3,127.88
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.
$5,726.00
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.
$1,030.68 with CLOVER 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 |
|---|---|---|---|
| CLOVER | MEDICARE ADVANTAGE | $1,030.68 | ↓ -67% |
| AETNA | MANAGED MEDICAID | $1,059.31 | ↓ -66% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,173.83 | ↓ -62% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -62% |
| HORIZON | MANAGED MEDICAID | $1,915.00 | ↓ -39% |
| QUALCARE | HMO | $2,744.00 | ↓ -12% |
| VACCN | ALL PRODUCTS | $3,127.88 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,127.88 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,127.88 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,127.88 | ↑ +0% |
| KARNA | MEDICARE ADVANTAGE | $3,235.73 | ↑ +3% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,284.27 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $3,409.39 | ↑ +9% |
| HORIZON | PIP | $3,727.63 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $3,753.45 | ↑ +20% |
| HORIZON | WORKERS COMP | $3,847.30 | ↑ +23% |
| HORIZON | OMNIA | $4,134.74 | ↑ +32% |
| BERGEN RISK | ALL PRODUCTS | $4,294.50 | ↑ +37% |
| AETNA | ASA | $4,483.46 | ↑ +43% |
| CIGNA | BH | $4,580.80 | ↑ +46% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,867.10 | ↑ +56% |
| HORIZON | SHP | $4,915.20 | ↑ +57% |
| AMERIHEALTH | LOCAL HMO | $4,972.46 | ↑ +59% |
| HORIZON | INDEMNITY | $5,096.14 | ↑ +63% |
| HORIZON | HMO | $5,099.58 | ↑ +63% |
| CIGNA | HMO | $5,147.10 | ↑ +65% |
| CIGNA | PPO | $5,147.10 | ↑ +65% |
| QUALCARE | WORKERS COMP | $5,199.21 | ↑ +66% |
| QUALCARE | PPO | $5,199.21 | ↑ +66% |
| HORIZON | PPO | $5,234.71 | ↑ +67% |
| AMERIHEALTH | REGIONAL HMO | $5,632.09 | ↑ +80% |
| OXFORD | ALL PRODUCTS | $8,251.00 | ↑ +164% |
| AETNA | PPO | $9,383.00 | ↑ +200% |
| AETNA | HMO | $9,383.00 | ↑ +200% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +218% |
| UNITED HEALTHCARE | HMO | $10,216.00 | ↑ +227% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Resect thigh/knee tum 5 cm/> at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $796.09 – $6,255.76 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $3,210.99 – $6,421.98 |
| Community Medical Center | Toms River | $3,786.00 | $3,127.88 – $6,224.48 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $3,210.99 – $6,389.87 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $819.50 – $6,421.98 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $1,030.23 – $6,707.33 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $3,167.89 – $6,304.10 |
| Bayshore Medical Center | Holmdel | $3,167.89 | $3,167.89 – $3,801.47 |