Small bowel endoscopy/biopsy at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$2,073.18
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.
$4,758.00
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.
$321.54 with KARNA vs $9,933.00 with BRIGHTON HEALTH PLAN — 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 | $321.54 | ↓ -84% |
| CLOVER | MEDICARE ADVANTAGE | $856.44 | ↓ -59% |
| AETNA | MANAGED MEDICAID | $880.23 | ↓ -58% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $975.39 | ↓ -53% |
| HORIZON | MANAGED MEDICAID | $1,188.00 | ↓ -43% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -43% |
| QUALCARE | HMO | $1,982.00 | ↓ -4% |
| WELLCARE | MANAGED MEDICAID | $2,073.18 | ↑ +0% |
| VACCN | ALL PRODUCTS | $2,073.18 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $2,073.18 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $2,073.18 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $2,176.84 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $2,259.77 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $2,487.82 | ↑ +20% |
| HORIZON | PIP | $3,097.46 | ↑ +49% |
| CIGNA | HMO | $3,133.00 | ↑ +51% |
| HORIZON | WORKERS COMP | $3,196.90 | ↑ +54% |
| HORIZON | OMNIA | $3,435.75 | ↑ +66% |
| CIGNA | PPO | $3,508.00 | ↑ +69% |
| BERGEN RISK | ALL PRODUCTS | $3,568.50 | ↑ +72% |
| AETNA | ASA | $3,725.51 | ↑ +80% |
| CIGNA | BH | $3,806.40 | ↑ +84% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,044.30 | ↑ +95% |
| HORIZON | SHP | $4,084.27 | ↑ +97% |
| AMERIHEALTH | LOCAL HMO | $4,131.85 | ↑ +99% |
| HORIZON | INDEMNITY | $4,234.62 | ↑ +104% |
| HORIZON | HMO | $4,237.47 | ↑ +104% |
| QUALCARE | WORKERS COMP | $4,320.26 | ↑ +108% |
| QUALCARE | PPO | $4,320.26 | ↑ +108% |
| HORIZON | PPO | $4,349.76 | ↑ +110% |
| AMERIHEALTH | REGIONAL HMO | $4,679.97 | ↑ +126% |
| OXFORD | ALL PRODUCTS | $6,189.00 | ↑ +199% |
| UNITED HEALTHCARE | HMO | $7,601.00 | ↑ +267% |
| AETNA | HMO | $9,383.00 | ↑ +353% |
| AETNA | PPO | $9,383.00 | ↑ +353% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +379% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Small bowel endoscopy/biopsy at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $79.11 – $4,146.36 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $270.58 – $4,256.54 |
| Community Medical Center | Toms River | $3,786.00 | $277.10 – $4,125.63 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $267.32 – $4,235.26 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $81.44 – $4,256.54 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $102.38 – $4,445.68 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $534.64 – $4,178.40 |
| Bayshore Medical Center | Holmdel | $2,099.70 | $2,099.70 – $2,519.64 |