Treatment of mouth lesion physical 40820 at Southern Ocean Medical Center
1140 Route 72 West, Manahawkin, NJ · Hackensack Meridian Health · · NPI 1831601590
$3,544.29
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.
$7,186.00
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.
$351.43 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 | $351.43 | ↓ -90% |
| HORIZON | MANAGED MEDICAID | $903.00 | ↓ -75% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -66% |
| CLOVER | MEDICARE ADVANTAGE | $1,293.48 | ↓ -64% |
| AETNA | MANAGED MEDICAID | $1,329.41 | ↓ -62% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,473.13 | ↓ -58% |
| QUALCARE | HMO | $1,525.00 | ↓ -57% |
| CIGNA | HMO | $2,249.00 | ↓ -37% |
| CIGNA | PPO | $2,518.00 | ↓ -29% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,544.29 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,544.29 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,544.29 | ↑ +0% |
| VACCN | ALL PRODUCTS | $3,544.29 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,721.50 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $3,863.27 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $4,253.14 | ↑ +20% |
| HORIZON | PIP | $4,678.09 | ↑ +32% |
| HORIZON | WORKERS COMP | $4,828.27 | ↑ +36% |
| HORIZON | OMNIA | $5,189.01 | ↑ +46% |
| BERGEN RISK | ALL PRODUCTS | $5,389.50 | ↑ +52% |
| AETNA | ASA | $5,626.64 | ↑ +59% |
| CIGNA | BH | $5,748.80 | ↑ +62% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $6,108.10 | ↑ +72% |
| HORIZON | SHP | $6,168.46 | ↑ +74% |
| OXFORD | ALL PRODUCTS | $6,189.00 | ↑ +75% |
| AMERIHEALTH | LOCAL HMO | $6,240.32 | ↑ +76% |
| HORIZON | INDEMNITY | $6,395.54 | ↑ +80% |
| HORIZON | HMO | $6,399.85 | ↑ +81% |
| QUALCARE | WORKERS COMP | $6,524.89 | ↑ +84% |
| QUALCARE | PPO | $6,524.89 | ↑ +84% |
| HORIZON | PPO | $6,569.44 | ↑ +85% |
| AMERIHEALTH | REGIONAL HMO | $7,068.15 | ↑ +99% |
| UNITED HEALTHCARE | HMO | $7,601.00 | ↑ +114% |
| AETNA | PPO | $9,383.00 | ↑ +165% |
| AETNA | HMO | $9,383.00 | ↑ +165% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +180% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Treatment of mouth lesion physical 40820 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $135.24 – $7,088.58 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $64.28 – $7,276.94 |
| Community Medical Center | Toms River | $3,786.00 | $65.82 – $7,053.14 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $63.50 – $7,240.56 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $116.55 – $7,276.94 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $69.70 – $7,600.27 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $127.00 – $7,143.34 |
| Bayshore Medical Center | Holmdel | $3,589.62 | $3,589.62 – $4,307.55 |