Nasal/sinus endo w/ethmoidectomy part 31254 at Jersey Shore University Medical Center
1945 NJ-33, Neptune City, NJ · Hackensack Meridian Health · · NPI 1790297547
$7,662.21
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.
?
What you pay up front if you don't use insurance.
$11,887.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$497.97 with KARNA vs $14,615.00 with HORIZON — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $497.97 | ↓ -94% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -84% |
| HORIZON | MANAGED MEDICAID | $1,482.00 | ↓ -81% |
| AETNA | MANAGED MEDICAID | $1,973.24 | ↓ -74% |
| CLOVER | MEDICARE ADVANTAGE | $2,139.66 | ↓ -72% |
| AETNA | MEDICARE ADVANTAGE | $2,520.04 | ↓ -67% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $2,745.90 | ↓ -64% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $2,757.78 | ↓ -64% |
| CIGNA | HMO | $3,586.00 | ↓ -53% |
| CIGNA | PPO | $4,013.00 | ↓ -48% |
| QUALCARE | HMO | $6,256.00 | ↓ -18% |
| WELLCARE | MANAGED MEDICAID | $7,662.21 | ↑ +0% |
| OPTUM HEALTH | MEDICARE ADVANTAGE | $7,662.21 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $7,662.21 | ↑ +0% |
| VACCN | ALL PRODUCTS | $7,662.21 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $8,045.32 | ↑ +5% |
| OXFORD | ALL PRODUCTS | $8,522.00 | ↑ +11% |
| BERGEN RISK | ALL PRODUCTS | $8,915.25 | ↑ +16% |
| BEACON | ALL PRODUCTS | $8,915.25 | ↑ +16% |
| HORIZON | PIP | $9,057.89 | ↑ +18% |
| UNITED HEALTHCARE | DSNP | $9,194.65 | ↑ +20% |
| QUALCARE | PPO | $9,236.20 | ↑ +21% |
| AETNA | ASA | $9,307.52 | ↑ +21% |
| HORIZON | OMNIA | $9,431.15 | ↑ +23% |
| CIGNA | BH | $9,509.60 | ↑ +24% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $10,103.95 | ↑ +32% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $10,103.95 | ↑ +32% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +33% |
| AETNA | PPO | $10,202.00 | ↑ +33% |
| AETNA | HMO | $10,202.00 | ↑ +33% |
| UNITED HEALTHCARE | HMO | $10,276.00 | ↑ +34% |
| AMERIHEALTH | LOCAL HMO | $10,384.48 | ↑ +36% |
| QUALCARE | WORKERS COMP | $10,460.56 | ↑ +37% |
| HORIZON | SHP | $11,486.00 | ↑ +50% |
| HORIZON | HMO | $11,599.33 | ↑ +51% |
| HORIZON | INDEMNITY | $11,726.53 | ↑ +53% |
| AMERIHEALTH | REGIONAL HMO | $11,761.00 | ↑ +53% |
| HORIZON | PPO | $11,887.00 | ↑ +55% |
| HORIZON | WORKERS COMP | $14,615.00 | ↑ +91% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| UBH | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Nasal/sinus endo w/ethmoidectomy part 31254 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $225.70 – $15,130.86 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $283.86 – $15,532.92 |
| Community Medical Center | Toms River | $3,786.00 | $290.70 – $15,055.21 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $280.44 – $15,455.26 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $232.33 – $15,532.92 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $292.08 – $16,223.12 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $560.88 – $15,247.80 |
| Bayshore Medical Center | Holmdel | $7,662.21 | $7,662.21 – $9,194.65 |