Optx medial ankle fx at Jersey Shore University Medical Center
1945 NJ-33, Neptune City, NJ · Hackensack Meridian Health · · NPI 1790297547
$7,907.11
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.
$11,054.00
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.
$1,277.54 with KARNA vs $23,535.00 with UNITED HEALTHCARE — 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 | $1,277.54 | ↓ -84% |
| HORIZON | MANAGED MEDICAID | $1,482.00 | ↓ -81% |
| AETNA | MANAGED MEDICAID | $1,834.96 | ↓ -77% |
| CLOVER | MEDICARE ADVANTAGE | $1,989.72 | ↓ -75% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $2,379.00 | ↓ -70% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $2,553.47 | ↓ -68% |
| CIGNA | HMO | $3,586.00 | ↓ -55% |
| CIGNA | PPO | $4,013.00 | ↓ -49% |
| QUALCARE | HMO | $6,256.00 | ↓ -21% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $7,907.11 | ↑ +0% |
| OPTUM HEALTH | MEDICARE ADVANTAGE | $7,907.11 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $7,907.11 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $7,907.11 | ↑ +0% |
| VACCN | ALL PRODUCTS | $7,907.11 | ↑ +0% |
| BEACON | ALL PRODUCTS | $8,290.50 | ↑ +5% |
| BERGEN RISK | ALL PRODUCTS | $8,290.50 | ↑ +5% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $8,302.46 | ↑ +5% |
| HORIZON | PIP | $8,423.15 | ↑ +7% |
| QUALCARE | PPO | $8,588.96 | ↑ +9% |
| AETNA | MEDICARE ADVANTAGE | $8,618.75 | ↑ +9% |
| AETNA | ASA | $8,655.28 | ↑ +9% |
| HORIZON | OMNIA | $8,770.24 | ↑ +11% |
| CIGNA | BH | $8,843.20 | ↑ +12% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $9,395.90 | ↑ +19% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $9,395.90 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $9,488.53 | ↑ +20% |
| AMERIHEALTH | LOCAL HMO | $9,656.77 | ↑ +22% |
| QUALCARE | WORKERS COMP | $9,727.52 | ↑ +23% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $10,163.00 | ↑ +29% |
| AETNA | HMO | $10,202.00 | ↑ +29% |
| AETNA | PPO | $10,202.00 | ↑ +29% |
| HORIZON | SHP | $10,730.12 | ↑ +36% |
| HORIZON | HMO | $10,786.49 | ↑ +36% |
| HORIZON | INDEMNITY | $10,904.77 | ↑ +38% |
| AMERIHEALTH | REGIONAL HMO | $10,936.83 | ↑ +38% |
| HORIZON | PPO | $11,054.00 | ↑ +40% |
| HORIZON | WORKERS COMP | $14,615.00 | ↑ +85% |
| OXFORD | ALL PRODUCTS | $19,413.00 | ↑ +146% |
| UNITED HEALTHCARE | HMO | $23,535.00 | ↑ +198% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| UBH | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Optx medial ankle fx at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $314.31 – $15,614.48 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $469.05 – $16,029.38 |
| Community Medical Center | Toms River | $3,786.00 | $480.35 – $15,536.41 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $463.40 – $15,949.23 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $323.56 – $16,029.38 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $406.76 – $16,741.65 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $926.80 – $15,735.15 |
| Bayshore Medical Center | Holmdel | $7,907.11 | $7,907.11 – $9,488.53 |