Quant diff pulm perf w/imaging at Jersey Shore University Medical Center
1945 NJ-33, Neptune City, NJ · Hackensack Meridian Health · · NPI 1790297547
$444.77
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.
$1,719.00
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.
$285.35 with AETNA vs $1,719.00 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 |
|---|---|---|---|
| AETNA | MANAGED MEDICAID | $285.35 | ↓ -36% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $302.35 | ↓ -32% |
| CLOVER | MEDICARE ADVANTAGE | $309.42 | ↓ -30% |
| KARNA | MEDICARE ADVANTAGE | $338.91 | ↓ -24% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $397.09 | ↓ -11% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $444.77 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $444.77 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $444.77 | ↑ +0% |
| VACCN | ALL PRODUCTS | $444.77 | ↑ +0% |
| OPTUM HEALTH | MEDICARE ADVANTAGE | $444.77 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $467.01 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $484.80 | ↑ +9% |
| AETNA | PPO | $507.87 | ↑ +14% |
| AETNA | HMO | $507.87 | ↑ +14% |
| UNITED HEALTHCARE | DSNP | $533.72 | ↑ +20% |
| CIGNA | HMO | $609.23 | ↑ +37% |
| CIGNA | PPO | $609.23 | ↑ +37% |
| AMERIHEALTH | LOCAL HMO | $666.56 | ↑ +50% |
| AMERIHEALTH | REGIONAL HMO | $678.09 | ↑ +52% |
| OXFORD | ALL PRODUCTS | $1,158.70 | ↑ +161% |
| UNITED HEALTHCARE | HMO | $1,158.70 | ↑ +161% |
| HORIZON | WORKERS COMP | $1,242.15 | ↑ +179% |
| BERGEN RISK | ALL PRODUCTS | $1,289.25 | ↑ +190% |
| BEACON | ALL PRODUCTS | $1,289.25 | ↑ +190% |
| HORIZON | PIP | $1,309.88 | ↑ +195% |
| QUALCARE | HMO | $1,335.66 | ↑ +200% |
| QUALCARE | PPO | $1,335.66 | ↑ +200% |
| AETNA | ASA | $1,345.98 | ↑ +203% |
| HORIZON | OMNIA | $1,363.85 | ↑ +207% |
| CIGNA | BH | $1,375.20 | ↑ +209% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $1,461.15 | ↑ +229% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $1,461.15 | ↑ +229% |
| QUALCARE | WORKERS COMP | $1,512.72 | ↑ +240% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $1,547.10 | ↑ +248% |
| HORIZON | SHP | $1,668.63 | ↑ +275% |
| HORIZON | HMO | $1,677.40 | ↑ +277% |
| HORIZON | INDEMNITY | $1,695.79 | ↑ +281% |
| HORIZON | PPO | $1,719.00 | ↑ +286% |
| UBH | ALL PRODUCTS | not published by hospital | — |
| HORIZON | MANAGED MEDICAID | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Quant diff pulm perf w/imaging at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $295.62 | $95.89 – $878.30 |
| Cooperman Barnabas Medical Center | Livingston | $501.35 | $143.50 – $901.64 |
| Community Medical Center | Toms River | $326.65 | $143.50 – $873.91 |
| Clara Maass Medical Center | Belleville | $261.75 | $143.50 – $897.13 |
| Newark Beth Israel Medical Center | Newark | $492.83 | $98.71 – $901.64 |
| Jersey City Medical Center | Jersey City | $327.28 | $124.09 – $941.71 |
| Monmouth Medical Center | Long Branch | $344.61 | $143.50 – $885.09 |
| Bayshore Medical Center | Holmdel | $444.77 | $302.35 – $1,021.05 |