Oropharyngeal biopsy 42800 at Palisades Medical Center
7600 River Rd., North Bergen, NJ · Hackensack Meridian Health · · NPI 1730692344
$1,744.44
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.
$7,186.00
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.
$256.36 with KARNA vs $16,802.00 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 | $256.36 | ↓ -85% |
| AETNA | MANAGED MEDICAID | $1,228.81 | ↓ -30% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,250.36 | ↓ -28% |
| CLOVER | MEDICARE ADVANTAGE | $1,293.48 | ↓ -26% |
| AMERIGROUP | MEDICARE ADVANTAGE | $1,744.44 | ↑ +0% |
| HORIZON | MEDICARE ADVANTAGE | $1,744.44 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,744.44 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $1,744.44 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $1,744.44 | ↑ +0% |
| VACCN | ALL PRODUCTS | $1,744.44 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $1,831.67 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $1,901.44 | ↑ +9% |
| HORIZON | MANAGED MEDICAID | $2,254.00 | ↑ +29% |
| OXFORD | ALL PRODUCTS | $4,047.00 | ↑ +132% |
| HORIZON | OMNIA | $4,916.66 | ↑ +182% |
| UNITED HEALTHCARE | HMO | $4,954.00 | ↑ +184% |
| BERGEN RISK | ALL PRODUCTS | $5,389.50 | ↑ +209% |
| HORIZON | PIP | $5,389.50 | ↑ +209% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $5,748.80 | ↑ +230% |
| HORIZON | SHP | $5,898.99 | ↑ +238% |
| AMERIHEALTH | LOCAL HMO | $6,016.84 | ↑ +245% |
| HORIZON | HMO | $6,076.48 | ↑ +248% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $6,108.10 | ↑ +250% |
| HORIZON | INDEMNITY | $6,123.91 | ↑ +251% |
| HORIZON | PPO | $6,230.26 | ↑ +257% |
| CIGNA | HMO | $6,459.50 | ↑ +270% |
| CIGNA | PPO | $6,459.50 | ↑ +270% |
| QUALCARE | HMO | $6,654.24 | ↑ +281% |
| QUALCARE | PPO | $6,654.24 | ↑ +281% |
| QUALCARE | WORKERS COMP | $6,654.24 | ↑ +281% |
| AMERIHEALTH | REGIONAL HMO | $6,715.32 | ↑ +285% |
| AETNA | HMO | $7,770.00 | ↑ +345% |
| AETNA | PPO | $7,770.00 | ↑ +345% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +469% |
| HORIZON | WORKERS COMP | $16,802.00 | ↑ +863% |
| UNITED HEALTHCARE | MANAGED MEDICAID | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Oropharyngeal biopsy 42800 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $82.64 – $3,237.72 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $41.83 – $3,323.76 |
| Community Medical Center | Toms River | $3,786.00 | $42.84 – $3,221.53 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $41.33 – $3,307.14 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $75.85 – $3,323.76 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $45.36 – $3,471.44 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $82.66 – $3,262.74 |
| Bayshore Medical Center | Holmdel | $1,639.57 | $1,639.57 – $1,967.48 |