Excision of lingual tonsil at Jersey Shore University Medical Center
1945 NJ-33, Neptune City, NJ · Hackensack Meridian Health · · NPI 1790297547
$6,547.81
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.
$9,266.00
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.
$1,189.00 with UNITED HEALTHCARE 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 |
|---|---|---|---|
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -82% |
| KARNA | MEDICARE ADVANTAGE | $1,239.76 | ↓ -81% |
| HORIZON | MANAGED MEDICAID | $1,482.00 | ↓ -77% |
| AETNA | MANAGED MEDICAID | $1,538.16 | ↓ -77% |
| CLOVER | MEDICARE ADVANTAGE | $1,667.88 | ↓ -75% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $2,140.45 | ↓ -67% |
| CIGNA | HMO | $3,586.00 | ↓ -45% |
| CIGNA | PPO | $4,013.00 | ↓ -39% |
| QUALCARE | HMO | $6,256.00 | ↓ -4% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $6,547.81 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $6,547.81 | ↑ +0% |
| OPTUM HEALTH | MEDICARE ADVANTAGE | $6,547.81 | ↑ +0% |
| VACCN | ALL PRODUCTS | $6,547.81 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $6,547.81 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $6,875.20 | ↑ +5% |
| BEACON | ALL PRODUCTS | $6,949.50 | ↑ +6% |
| BERGEN RISK | ALL PRODUCTS | $6,949.50 | ↑ +6% |
| HORIZON | PIP | $7,060.69 | ↑ +8% |
| AETNA | MEDICARE ADVANTAGE | $7,137.11 | ↑ +9% |
| QUALCARE | PPO | $7,199.68 | ↑ +10% |
| AETNA | ASA | $7,255.28 | ↑ +11% |
| HORIZON | OMNIA | $7,351.64 | ↑ +12% |
| CIGNA | BH | $7,412.80 | ↑ +13% |
| UNITED HEALTHCARE | DSNP | $7,857.37 | ↑ +20% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $7,876.10 | ↑ +20% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $7,876.10 | ↑ +20% |
| AMERIHEALTH | LOCAL HMO | $8,094.78 | ↑ +24% |
| QUALCARE | WORKERS COMP | $8,154.08 | ↑ +25% |
| OXFORD | ALL PRODUCTS | $8,522.00 | ↑ +30% |
| HORIZON | SHP | $8,994.51 | ↑ +37% |
| HORIZON | HMO | $9,041.76 | ↑ +38% |
| HORIZON | INDEMNITY | $9,140.91 | ↑ +40% |
| AMERIHEALTH | REGIONAL HMO | $9,167.78 | ↑ +40% |
| HORIZON | PPO | $9,266.00 | ↑ +42% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +55% |
| AETNA | PPO | $10,202.00 | ↑ +56% |
| AETNA | HMO | $10,202.00 | ↑ +56% |
| UNITED HEALTHCARE | HMO | $10,276.00 | ↑ +57% |
| HORIZON | WORKERS COMP | $14,615.00 | ↑ +123% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| UBH | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Excision of lingual tonsil at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $6,547.81 | $6,547.81 – $7,857.37 |
| Hackensack University Medical Center | Hackensack | $6,966.64 | $1,294.24 – $7,314.97 |
| Ocean University Medical Center | Brick | $6,465.11 | $1,239.76 – $7,758.13 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $6,553.49 | $170.80 – $6,553.49 |
| Palisades Medical Center | North Bergen | $6,966.64 | $1,294.24 – $7,593.63 |
| Raritan Bay Medical Center | Perth Amboy | $6,553.49 | $1,294.24 – $7,864.18 |
| Riverview Medical Center | Red Bank | $6,547.81 | $1,239.76 – $7,857.37 |
| Southern Ocean Medical Center | Manahawkin | $6,465.11 | $1,239.76 – $7,758.13 |