Arthro/shoul surg; w/spacer at Riverview Medical Center
1 Riverview Plaza, Red Bank, NJ · Hackensack Meridian Health · · NPI 1710499462
$14,241.77
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.
$21,209.00
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.
$1,892.00 with HORIZON vs $23,258.00 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 |
|---|---|---|---|
| HORIZON | MANAGED MEDICAID | $1,892.00 | ↓ -87% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $2,379.00 | ↓ -83% |
| AETNA | MANAGED MEDICAID | $2,990.47 | ↓ -79% |
| CLOVER | MEDICARE ADVANTAGE | $3,817.62 | ↓ -73% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $4,602.35 | ↓ -68% |
| QUALCARE | HMO | $6,256.00 | ↓ -56% |
| HORIZON | OMNIA | $6,990.00 | ↓ -51% |
| HORIZON | SHP | $7,997.00 | ↓ -44% |
| AETNA | HMO | $8,419.00 | ↓ -41% |
| AETNA | PPO | $8,419.00 | ↓ -41% |
| HORIZON | HMO | $8,624.00 | ↓ -39% |
| HORIZON | INDEMNITY | $8,743.00 | ↓ -39% |
| HORIZON | PPO | $8,826.00 | ↓ -38% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↓ -30% |
| QUALCARE | PPO | $10,231.00 | ↓ -28% |
| HORIZON | WORKERS COMP | $10,715.00 | ↓ -25% |
| QUALCARE | WORKERS COMP | $10,822.00 | ↓ -24% |
| AMERIHEALTH | LOCAL HMO | $13,972.00 | ↓ -2% |
| WELLCARE | MEDICARE ADVANTAGE | $14,241.77 | ↑ +0% |
| VACCN | ALL PRODUCTS | $14,241.77 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $14,241.77 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $14,241.77 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $14,953.86 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $15,523.53 | ↑ +9% |
| BERGEN RISK | ALL PRODUCTS | $15,603.00 | ↑ +10% |
| AMERIHEALTH | REGIONAL HMO | $15,795.00 | ↑ +11% |
| AETNA | ASA | $16,606.65 | ↑ +17% |
| HORIZON | PIP | $16,733.90 | ↑ +17% |
| CIGNA | BH | $16,967.20 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $17,090.12 | ↑ +20% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $18,027.65 | ↑ +27% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $18,027.65 | ↑ +27% |
| OXFORD | ALL PRODUCTS | $18,636.00 | ↑ +31% |
| CIGNA | HMO | $19,064.77 | ↑ +34% |
| CIGNA | PPO | $19,064.77 | ↑ +34% |
| UNITED HEALTHCARE | HMO | $23,258.00 | ↑ +63% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Arthro/shoul surg; w/spacer at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $14,254.12 | $12,866.82 – $14,254.12 |
| Jersey Shore University Medical Center | Neptune City | $14,241.77 | $14,241.77 – $17,090.12 |
| Palisades Medical Center | North Bergen | $15,152.74 | $15,152.74 – $16,516.49 |
| Raritan Bay Medical Center | Perth Amboy | $14,254.12 | $14,254.12 – $17,104.94 |
| Southern Ocean Medical Center | Manahawkin | $14,061.89 | $14,061.89 – $16,874.27 |