Excision breast lesion at Jersey Shore University Medical Center
1945 NJ-33, Neptune City, NJ · Hackensack Meridian Health · · NPI 1790297547
$4,238.48
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.
$8,392.00
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.
$966.80 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 | $966.80 | ↓ -77% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -72% |
| AETNA | MANAGED MEDICAID | $1,393.07 | ↓ -67% |
| HORIZON | MANAGED MEDICAID | $1,482.00 | ↓ -65% |
| CLOVER | MEDICARE ADVANTAGE | $1,510.56 | ↓ -64% |
| AETNA | MEDICARE ADVANTAGE | $1,779.10 | ↓ -58% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,938.55 | ↓ -54% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,946.94 | ↓ -54% |
| CIGNA | HMO | $3,586.00 | ↓ -15% |
| CIGNA | PPO | $4,013.00 | ↓ -5% |
| OPTUM HEALTH | MEDICARE ADVANTAGE | $4,238.48 | ↑ +0% |
| VACCN | ALL PRODUCTS | $4,238.48 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,238.48 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $4,238.48 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,450.40 | ↑ +5% |
| UNITED HEALTHCARE | DSNP | $5,086.17 | ↑ +20% |
| QUALCARE | HMO | $6,256.00 | ↑ +48% |
| BEACON | ALL PRODUCTS | $6,294.00 | ↑ +48% |
| BERGEN RISK | ALL PRODUCTS | $6,294.00 | ↑ +48% |
| HORIZON | PIP | $6,394.70 | ↑ +51% |
| QUALCARE | PPO | $6,520.58 | ↑ +54% |
| AETNA | ASA | $6,570.94 | ↑ +55% |
| HORIZON | OMNIA | $6,658.21 | ↑ +57% |
| CIGNA | BH | $6,713.60 | ↑ +58% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $7,133.20 | ↑ +68% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $7,133.20 | ↑ +68% |
| AMERIHEALTH | LOCAL HMO | $7,331.25 | ↑ +73% |
| QUALCARE | WORKERS COMP | $7,384.96 | ↑ +74% |
| HORIZON | SHP | $8,146.11 | ↑ +92% |
| HORIZON | HMO | $8,188.91 | ↑ +93% |
| HORIZON | INDEMNITY | $8,278.71 | ↑ +95% |
| AMERIHEALTH | REGIONAL HMO | $8,303.04 | ↑ +96% |
| HORIZON | PPO | $8,392.00 | ↑ +98% |
| OXFORD | ALL PRODUCTS | $8,522.00 | ↑ +101% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +140% |
| AETNA | HMO | $10,202.00 | ↑ +141% |
| AETNA | PPO | $10,202.00 | ↑ +141% |
| UNITED HEALTHCARE | HMO | $10,276.00 | ↑ +142% |
| HORIZON | WORKERS COMP | $14,615.00 | ↑ +245% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| UBH | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Excision breast lesion at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $4,238.48 | $4,238.48 – $5,086.17 |
| Hackensack University Medical Center | Hackensack | $4,509.59 | $996.17 – $4,735.07 |
| Ocean University Medical Center | Brick | $4,184.94 | $966.80 – $5,829.14 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $4,242.15 | $313.32 – $5,829.14 |
| Palisades Medical Center | North Bergen | $4,509.59 | $308.62 – $4,915.45 |
| Raritan Bay Medical Center | Perth Amboy | $4,242.15 | $391.65 – $5,090.58 |
| Riverview Medical Center | Red Bank | $4,238.48 | $966.80 – $5,086.17 |
| Southern Ocean Medical Center | Manahawkin | $4,184.94 | $966.80 – $5,021.93 |