Calculi urinary-sendout at Raritan Bay Medical Center
530 New Brunswick Avenue, Perth Amboy, NJ · Hackensack Meridian Health · · NPI 1790297455
$12.87
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.
$28.00
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.
$3.72 with AETNA vs $58.97 with CIGNA — 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 | $3.72 | ↓ -71% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $12.87 | ↑ +0% |
| CLOVER | MEDICARE ADVANTAGE | $12.87 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $12.87 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $12.87 | ↑ +0% |
| VACCN | ALL PRODUCTS | $12.87 | ↑ +0% |
| AMERIGROUP | MANAGED MEDICAID | $12.87 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $13.51 | ↑ +5% |
| AMERIGROUP | MEDICARE ADVANTAGE | $13.77 | ↑ +7% |
| AETNA | MEDICARE ADVANTAGE | $14.03 | ↑ +9% |
| UNITED HEALTHCARE | DSNP | $15.44 | ↑ +20% |
| KARNA | MEDICARE ADVANTAGE | $17.12 | ↑ +33% |
| QUALCARE | WORKERS COMP | $18.62 | ↑ +45% |
| AETNA | PPO | $19.26 | ↑ +50% |
| AETNA | HMO | $19.26 | ↑ +50% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $21.00 | ↑ +63% |
| BERGEN RISK | ALL PRODUCTS | $21.00 | ↑ +63% |
| HORIZON | OMNIA | $21.39 | ↑ +66% |
| HORIZON | PIP | $21.67 | ↑ +68% |
| HORIZON | WORKERS COMP | $21.82 | ↑ +70% |
| AETNA | ASA | $21.92 | ↑ +70% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $22.40 | ↑ +74% |
| CIGNA | BH | $22.40 | ↑ +74% |
| HORIZON | INDEMNITY | $23.53 | ↑ +83% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $23.80 | ↑ +85% |
| AMERIHEALTH | LOCAL HMO | $24.23 | ↑ +88% |
| QUALCARE | HMO | $25.42 | ↑ +98% |
| QUALCARE | PPO | $25.42 | ↑ +98% |
| HORIZON | SHP | $26.12 | ↑ +103% |
| HORIZON | HMO | $26.38 | ↑ +105% |
| OXFORD | ALL PRODUCTS | $26.42 | ↑ +105% |
| UNITED HEALTHCARE | HMO | $26.42 | ↑ +105% |
| HORIZON | PPO | $27.05 | ↑ +110% |
| AMERIHEALTH | REGIONAL HMO | $27.24 | ↑ +112% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $28.26 | ↑ +120% |
| CIGNA | HMO | $58.97 | ↑ +358% |
| CIGNA | PPO | $58.97 | ↑ +358% |
| HORIZON | MANAGED MEDICAID | not published by hospital | — |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Calculi urinary-sendout at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $12.87 | $12.87 – $58.97 |
| Hackensack University Medical Center | Hackensack | $12.87 | $10.30 – $57.79 |
| Ocean University Medical Center | Brick | $12.87 | $12.87 – $58.97 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $12.87 | $12.87 – $60.57 |
| Jersey Shore University Medical Center | Neptune City | $12.87 | $10.30 – $58.97 |
| Palisades Medical Center | North Bergen | $12.87 | $12.87 – $58.97 |
| Riverview Medical Center | Red Bank | $12.87 | $12.87 – $58.97 |
| Southern Ocean Medical Center | Manahawkin | $12.87 | $12.87 – $58.97 |