Biopsy of upper nose/throat at Jersey Shore University Medical Center
1945 NJ-33, Neptune City, NJ · Hackensack Meridian Health · · NPI 1790297547
$3,589.62
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.
$5,304.00
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.
$260.95 with KARNA vs $14,615.00 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 |
|---|---|---|---|
| KARNA | MEDICARE ADVANTAGE | $260.95 | ↓ -93% |
| AETNA | MANAGED MEDICAID | $880.46 | ↓ -75% |
| CLOVER | MEDICARE ADVANTAGE | $954.72 | ↓ -73% |
| HORIZON | MANAGED MEDICAID | $983.00 | ↓ -73% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -67% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,225.22 | ↓ -66% |
| CIGNA | HMO | $2,247.00 | ↓ -37% |
| CIGNA | PPO | $2,518.00 | ↓ -30% |
| OPTUM HEALTH | MEDICARE ADVANTAGE | $3,589.62 | ↑ +0% |
| VACCN | ALL PRODUCTS | $3,589.62 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,589.62 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,589.62 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,589.62 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,769.11 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $3,912.69 | ↑ +9% |
| BEACON | ALL PRODUCTS | $3,978.00 | ↑ +11% |
| BERGEN RISK | ALL PRODUCTS | $3,978.00 | ↑ +11% |
| HORIZON | PIP | $4,041.65 | ↑ +13% |
| QUALCARE | PPO | $4,121.21 | ↑ +15% |
| AETNA | ASA | $4,153.03 | ↑ +16% |
| HORIZON | OMNIA | $4,208.19 | ↑ +17% |
| CIGNA | BH | $4,243.20 | ↑ +18% |
| UNITED HEALTHCARE | DSNP | $4,307.55 | ↑ +20% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $4,508.40 | ↑ +26% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,508.40 | ↑ +26% |
| AMERIHEALTH | LOCAL HMO | $4,633.57 | ↑ +29% |
| QUALCARE | WORKERS COMP | $4,667.52 | ↑ +30% |
| HORIZON | SHP | $5,148.59 | ↑ +43% |
| HORIZON | HMO | $5,175.64 | ↑ +44% |
| HORIZON | INDEMNITY | $5,232.40 | ↑ +46% |
| AMERIHEALTH | REGIONAL HMO | $5,247.78 | ↑ +46% |
| HORIZON | PPO | $5,304.00 | ↑ +48% |
| QUALCARE | HMO | $6,256.00 | ↑ +74% |
| OXFORD | ALL PRODUCTS | $6,345.00 | ↑ +77% |
| UNITED HEALTHCARE | HMO | $7,625.00 | ↑ +112% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +183% |
| AETNA | HMO | $10,202.00 | ↑ +184% |
| AETNA | PPO | $10,202.00 | ↑ +184% |
| HORIZON | WORKERS COMP | $14,615.00 | ↑ +307% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| UBH | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of upper nose/throat at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $3,589.62 | $3,589.62 – $4,307.55 |
| Hackensack University Medical Center | Hackensack | $3,819.23 | $271.94 – $4,010.20 |
| Ocean University Medical Center | Brick | $3,544.29 | $260.95 – $4,253.14 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $3,592.74 | $94.38 – $3,592.74 |
| Palisades Medical Center | North Bergen | $3,819.23 | $271.94 – $4,162.96 |
| Raritan Bay Medical Center | Perth Amboy | $3,592.74 | $271.94 – $4,311.29 |
| Riverview Medical Center | Red Bank | $3,589.62 | $260.95 – $4,307.55 |
| Southern Ocean Medical Center | Manahawkin | $3,544.29 | $260.95 – $4,253.14 |