Oth resp proc, group at Raritan Bay Medical Center
530 New Brunswick Avenue, Perth Amboy, NJ · Hackensack Meridian Health · · NPI 1790297455
$43.48
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.
$385.00
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.
$24.81 with KARNA vs $2,682.00 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 | $24.81 | ↓ -43% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $43.48 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $43.48 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $43.48 | ↑ +0% |
| VACCN | ALL PRODUCTS | $43.48 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $45.66 | ↑ +5% |
| AMERIGROUP | MEDICARE ADVANTAGE | $46.53 | ↑ +7% |
| AETNA | MEDICARE ADVANTAGE | $47.40 | ↑ +9% |
| AETNA | MANAGED MEDICAID | $51.21 | ↑ +18% |
| UNITED HEALTHCARE | DSNP | $52.18 | ↑ +20% |
| CLOVER | MEDICARE ADVANTAGE | $69.30 | ↑ +59% |
| HORIZON | MANAGED MEDICAID | $70.00 | ↑ +61% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $79.70 | ↑ +83% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $226.77 | ↑ +422% |
| QUALCARE | WORKERS COMP | $256.03 | ↑ +489% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $288.75 | ↑ +564% |
| BERGEN RISK | ALL PRODUCTS | $288.75 | ↑ +564% |
| HORIZON | OMNIA | $294.14 | ↑ +576% |
| HORIZON | PIP | $297.99 | ↑ +585% |
| HORIZON | WORKERS COMP | $300.07 | ↑ +590% |
| AETNA | ASA | $301.46 | ↑ +593% |
| CIGNA | BH | $308.00 | ↑ +608% |
| HORIZON | INDEMNITY | $323.52 | ↑ +644% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $327.25 | ↑ +653% |
| AMERIHEALTH | LOCAL HMO | $333.22 | ↑ +666% |
| AETNA | HMO | $346.50 | ↑ +697% |
| AETNA | PPO | $346.50 | ↑ +697% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $346.50 | ↑ +697% |
| QUALCARE | HMO | $349.58 | ↑ +704% |
| QUALCARE | PPO | $349.58 | ↑ +704% |
| HORIZON | SHP | $359.21 | ↑ +726% |
| HORIZON | HMO | $362.67 | ↑ +734% |
| CIGNA | HMO | $368.18 | ↑ +747% |
| CIGNA | PPO | $368.18 | ↑ +747% |
| HORIZON | PPO | $371.91 | ↑ +755% |
| AMERIHEALTH | REGIONAL HMO | $374.57 | ↑ +761% |
| OXFORD | ALL PRODUCTS | $396.00 | ↑ +811% |
| UNITED HEALTHCARE | HMO | $2,682.00 | ↑ +6068% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Oth resp proc, group at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $57.81 | $42.90 – $85.80 |
| Cooperman Barnabas Medical Center | Livingston | $90.26 | $44.04 – $88.08 |
| Community Medical Center | Toms River | $63.87 | $42.90 – $85.37 |
| Clara Maass Medical Center | Belleville | $71.80 | $44.04 – $87.64 |
| Monmouth Medical Center | Long Branch | $67.39 | $43.44 – $326.00 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $43.48 | $24.81 – $342.00 |
| Jersey Shore University Medical Center | Neptune City | $43.44 | $23.46 – $604.00 |
| Palisades Medical Center | North Bergen | $46.22 | $24.81 – $444.00 |