Exc breast duct fistula 19112 at Raritan Bay Medical Center
530 New Brunswick Avenue, Perth Amboy, NJ · Hackensack Meridian Health · · NPI 1790297455
$4,242.15
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.
$6,684.00
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.
$706.74 with KARNA vs $10,156.00 with UNITED HEALTHCARE — 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 | $706.74 | ↓ -83% |
| AETNA | MANAGED MEDICAID | $888.97 | ↓ -79% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -72% |
| CLOVER | MEDICARE ADVANTAGE | $1,203.12 | ↓ -72% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,383.59 | ↓ -67% |
| HORIZON | MANAGED MEDICAID | $2,438.00 | ↓ -43% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $2,915.00 | ↓ -31% |
| AMERIHEALTH | LOCAL HMO | $3,154.84 | ↓ -26% |
| CIGNA | HMO | $3,412.00 | ↓ -20% |
| AMERIHEALTH | REGIONAL HMO | $3,525.08 | ↓ -17% |
| CIGNA | PPO | $3,817.00 | ↓ -10% |
| WELLCARE | MEDICARE ADVANTAGE | $4,242.15 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $4,242.15 | ↑ +0% |
| VACCN | ALL PRODUCTS | $4,242.15 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,242.15 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,454.26 | ↑ +5% |
| AMERIGROUP | MEDICARE ADVANTAGE | $4,539.10 | ↑ +7% |
| AETNA | MEDICARE ADVANTAGE | $4,623.95 | ↑ +9% |
| BERGEN RISK | ALL PRODUCTS | $5,013.00 | ↑ +18% |
| UNITED HEALTHCARE | DSNP | $5,090.58 | ↑ +20% |
| HORIZON | OMNIA | $5,106.58 | ↑ +20% |
| AETNA | ASA | $5,233.57 | ↑ +23% |
| CIGNA | BH | $5,347.20 | ↑ +26% |
| QUALCARE | WORKERS COMP | $5,366.00 | ↑ +26% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,681.40 | ↑ +34% |
| QUALCARE | PPO | $5,881.92 | ↑ +39% |
| QUALCARE | HMO | $5,881.92 | ↑ +39% |
| HORIZON | SHP | $6,236.17 | ↑ +47% |
| HORIZON | HMO | $6,296.33 | ↑ +48% |
| HORIZON | INDEMNITY | $6,383.22 | ↑ +50% |
| HORIZON | WORKERS COMP | $6,415.00 | ↑ +51% |
| HORIZON | PPO | $6,456.74 | ↑ +52% |
| HORIZON | PIP | $6,602.00 | ↑ +56% |
| OXFORD | ALL PRODUCTS | $8,086.00 | ↑ +91% |
| AETNA | HMO | $8,419.00 | ↑ +98% |
| AETNA | PPO | $8,419.00 | ↑ +98% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +134% |
| UNITED HEALTHCARE | HMO | $10,156.00 | ↑ +139% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Exc breast duct fistula 19112 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $4,238.48 | $4,238.48 – $5,086.17 |
| Hackensack University Medical Center | Hackensack | $4,509.59 | $706.74 – $4,735.07 |
| Ocean University Medical Center | Brick | $4,184.94 | $682.27 – $5,021.93 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $4,242.15 | $250.48 – $4,242.15 |
| Jersey Shore University Medical Center | Neptune City | $4,238.48 | $682.27 – $5,086.17 |
| Palisades Medical Center | North Bergen | $4,509.59 | $706.74 – $4,915.45 |
| Riverview Medical Center | Red Bank | $4,238.48 | $682.27 – $5,086.17 |
| Southern Ocean Medical Center | Manahawkin | $4,184.94 | $682.27 – $5,021.93 |