Aco annual medicare visit (awv), initial g0438aco at Jersey Shore University Medical Center
1945 NJ-33, Neptune City, NJ · Hackensack Meridian Health · · NPI 1790297547
$206.14
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.
$517.00
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.
$85.82 with AETNA vs $517.00 with HORIZON — 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 |
|---|---|---|---|
| AETNA | MANAGED MEDICAID | $85.82 | ↓ -58% |
| CLOVER | MEDICARE ADVANTAGE | $93.06 | ↓ -55% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $119.43 | ↓ -42% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $119.94 | ↓ -42% |
| OPTUM HEALTH | MANAGED MEDICAID | $164.91 | ↓ -20% |
| AMERIGROUP | MANAGED MEDICAID | $206.14 | ↑ +0% |
| OPTUM HEALTH | MEDICARE ADVANTAGE | $206.14 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $206.14 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $206.14 | ↑ +0% |
| VACCN | ALL PRODUCTS | $206.14 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $216.45 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $224.69 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $247.37 | ↑ +20% |
| KARNA | MEDICARE ADVANTAGE | $289.84 | ↑ +41% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $304.51 | ↑ +48% |
| OXFORD | ALL PRODUCTS | $352.28 | ↑ +71% |
| HORIZON | MANAGED MEDICAID | $356.68 | ↑ +73% |
| HORIZON | WORKERS COMP | $373.58 | ↑ +81% |
| BEACON | ALL PRODUCTS | $387.75 | ↑ +88% |
| BERGEN RISK | ALL PRODUCTS | $387.75 | ↑ +88% |
| HORIZON | PIP | $393.95 | ↑ +91% |
| QUALCARE | PPO | $401.71 | ↑ +95% |
| QUALCARE | HMO | $401.71 | ↑ +95% |
| AETNA | ASA | $404.81 | ↑ +96% |
| HORIZON | OMNIA | $410.19 | ↑ +99% |
| CIGNA | BH | $413.60 | ↑ +101% |
| UNITED HEALTHCARE | HMO | $439.29 | ↑ +113% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $439.45 | ↑ +113% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $439.45 | ↑ +113% |
| AMERIHEALTH | LOCAL HMO | $451.65 | ↑ +119% |
| QUALCARE | WORKERS COMP | $454.96 | ↑ +121% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $465.30 | ↑ +126% |
| AETNA | HMO | $465.30 | ↑ +126% |
| AETNA | PPO | $465.30 | ↑ +126% |
| CIGNA | PPO | $494.41 | ↑ +140% |
| CIGNA | HMO | $494.41 | ↑ +140% |
| HORIZON | SHP | $501.85 | ↑ +143% |
| HORIZON | HMO | $504.49 | ↑ +145% |
| HORIZON | INDEMNITY | $510.02 | ↑ +147% |
| AMERIHEALTH | REGIONAL HMO | $511.52 | ↑ +148% |
| HORIZON | PPO | $517.00 | ↑ +151% |
| UBH | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Aco annual medicare visit (awv), initial g0438aco at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $206.14 | $206.14 – $300.52 |
| Palisades Medical Center | North Bergen | $206.14 | $206.14 – $300.52 |
| Raritan Bay Medical Center | Perth Amboy | $206.14 | $206.14 – $300.52 |
| Riverview Medical Center | Red Bank | $206.14 | $206.14 – $289.84 |
| Southern Ocean Medical Center | Manahawkin | $206.14 | $206.14 – $289.84 |