Rmvl icd gen w/rplc icd gen dual lead sys at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$24,530.99
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.
$51,396.00
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.
$786.03 with KARNA vs $137,045.00 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 | $786.03 | ↓ -97% |
| CLOVER | MEDICARE ADVANTAGE | $9,251.28 | ↓ -62% |
| AETNA | MANAGED MEDICAID | $9,508.26 | ↓ -61% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $10,536.18 | ↓ -57% |
| WELLCARE | MANAGED MEDICAID | $24,530.99 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $24,530.99 | ↑ +0% |
| VACCN | ALL PRODUCTS | $24,530.99 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $24,530.99 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $25,757.54 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $26,738.78 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $29,437.19 | ↑ +20% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $30,272.24 | ↑ +23% |
| HORIZON | MANAGED MEDICAID | $32,574.78 | ↑ +33% |
| HORIZON | PIP | $33,458.80 | ↑ +36% |
| HORIZON | WORKERS COMP | $34,532.97 | ↑ +41% |
| OXFORD | ALL PRODUCTS | $36,537.42 | ↑ +49% |
| HORIZON | OMNIA | $37,113.05 | ↑ +51% |
| BERGEN RISK | ALL PRODUCTS | $38,547.00 | ↑ +57% |
| AETNA | ASA | $40,243.07 | ↑ +64% |
| CIGNA | BH | $41,116.80 | ↑ +68% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $43,686.60 | ↑ +78% |
| HORIZON | SHP | $44,118.33 | ↑ +80% |
| AMERIHEALTH | LOCAL HMO | $44,632.29 | ↑ +82% |
| HORIZON | INDEMNITY | $45,742.44 | ↑ +86% |
| HORIZON | HMO | $45,773.28 | ↑ +87% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $46,256.40 | ↑ +89% |
| AETNA | HMO | $46,266.68 | ↑ +89% |
| AETNA | PPO | $46,266.68 | ↑ +89% |
| QUALCARE | HMO | $46,667.57 | ↑ +90% |
| QUALCARE | PPO | $46,667.57 | ↑ +90% |
| QUALCARE | WORKERS COMP | $46,667.57 | ↑ +90% |
| HORIZON | PPO | $46,986.22 | ↑ +92% |
| CIGNA | PPO | $49,149.99 | ↑ +100% |
| CIGNA | HMO | $49,149.99 | ↑ +100% |
| AMERIHEALTH | REGIONAL HMO | $50,553.11 | ↑ +106% |
| UNITED HEALTHCARE | HMO | $137,045.00 | ↑ +459% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Rmvl icd gen w/rplc icd gen dual lead sys at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $193.39 – $49,061.98 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $25,182.83 – $50,365.66 |
| Community Medical Center | Toms River | $3,786.00 | $24,530.99 – $48,816.67 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $25,182.83 – $50,113.83 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $199.08 – $50,365.66 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $250.27 – $52,603.62 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $24,844.79 – $49,441.13 |
| Bayshore Medical Center | Holmdel | $24,844.79 | $24,844.79 – $29,813.75 |