Revision of iris at Raritan Bay Medical Center
530 New Brunswick Avenue, Perth Amboy, NJ · Hackensack Meridian Health · · NPI 1790297455
$607.75
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.
$2,537.00
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.
$337.42 with AETNA vs $8,419.00 with AETNA — 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 | $337.42 | ↓ -44% |
| AETNA | MEDICARE ADVANTAGE | $393.24 | ↓ -35% |
| HORIZON | MANAGED MEDICAID | $417.65 | ↓ -31% |
| CLOVER | MEDICARE ADVANTAGE | $456.66 | ↓ -25% |
| KARNA | MEDICARE ADVANTAGE | $508.22 | ↓ -16% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $525.16 | ↓ -14% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $607.75 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $607.75 | ↑ +0% |
| VACCN | ALL PRODUCTS | $607.75 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $607.75 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $638.14 | ↑ +5% |
| AMERIGROUP | MEDICARE ADVANTAGE | $650.29 | ↑ +7% |
| UNITED HEALTHCARE | DSNP | $729.30 | ↑ +20% |
| AMERIHEALTH | LOCAL HMO | $1,456.08 | ↑ +140% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,494.29 | ↑ +146% |
| OXFORD | ALL PRODUCTS | $1,563.81 | ↑ +157% |
| AMERIHEALTH | REGIONAL HMO | $1,626.96 | ↑ +168% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $1,902.75 | ↑ +213% |
| BERGEN RISK | ALL PRODUCTS | $1,902.75 | ↑ +213% |
| AETNA | ASA | $1,986.47 | ↑ +227% |
| CIGNA | BH | $2,029.60 | ↑ +234% |
| UNITED HEALTHCARE | HMO | $2,065.88 | ↑ +240% |
| CIGNA | HMO | $2,139.00 | ↑ +252% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $2,156.45 | ↑ +255% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $2,283.30 | ↑ +276% |
| QUALCARE | PPO | $2,303.60 | ↑ +279% |
| QUALCARE | HMO | $2,303.60 | ↑ +279% |
| CIGNA | PPO | $2,396.00 | ↑ +294% |
| QUALCARE | WORKERS COMP | $5,366.00 | ↑ +783% |
| HORIZON | WORKERS COMP | $6,415.00 | ↑ +956% |
| HORIZON | OMNIA | $6,440.00 | ↑ +960% |
| HORIZON | PIP | $6,602.00 | ↑ +986% |
| HORIZON | SHP | $7,445.00 | ↑ +1125% |
| HORIZON | HMO | $7,956.00 | ↑ +1209% |
| HORIZON | INDEMNITY | $8,061.00 | ↑ +1226% |
| HORIZON | PPO | $8,159.00 | ↑ +1242% |
| AETNA | PPO | $8,419.00 | ↑ +1285% |
| AETNA | HMO | $8,419.00 | ↑ +1285% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Revision of iris at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $153.50 – $1,199.10 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $277.32 – $1,230.98 |
| Community Medical Center | Toms River | $3,786.00 | $284.00 – $1,193.10 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $273.98 – $1,224.83 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $158.01 – $1,230.98 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $198.65 – $1,285.66 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $547.96 – $1,208.37 |
| Bayshore Medical Center | Holmdel | $607.22 | $607.22 – $728.67 |