Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah) at Riverview Medical Center
1 Riverview Plaza, Red Bank, NJ · Hackensack Meridian Health · · NPI 1710499462
$3,591.33
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.
$5,304.00
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.
$747.86 with AETNA 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 |
|---|---|---|---|
| AETNA | MANAGED MEDICAID | $747.86 | ↓ -79% |
| CLOVER | MEDICARE ADVANTAGE | $954.72 | ↓ -73% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,150.97 | ↓ -68% |
| KARNA | MEDICARE ADVANTAGE | $1,427.13 | ↓ -60% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $2,379.00 | ↓ -34% |
| HORIZON | MANAGED MEDICAID | $3,265.00 | ↓ -9% |
| HORIZON | OMNIA | $3,382.89 | ↓ -6% |
| VACCN | ALL PRODUCTS | $3,591.33 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $3,591.33 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,591.33 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $3,591.33 | ↑ +0% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $3,770.90 | ↑ +5% |
| AETNA | MEDICARE ADVANTAGE | $3,914.55 | ↑ +9% |
| BERGEN RISK | ALL PRODUCTS | $3,978.00 | ↑ +11% |
| HORIZON | SHP | $4,081.43 | ↑ +14% |
| QUALCARE | PPO | $4,121.21 | ↑ +15% |
| AETNA | ASA | $4,153.03 | ↑ +16% |
| HORIZON | HMO | $4,184.33 | ↑ +17% |
| HORIZON | PIP | $4,184.86 | ↑ +17% |
| CIGNA | BH | $4,243.20 | ↑ +18% |
| HORIZON | INDEMNITY | $4,244.79 | ↑ +18% |
| HORIZON | PPO | $4,281.92 | ↑ +19% |
| UNITED HEALTHCARE | DSNP | $4,309.59 | ↑ +20% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $4,508.40 | ↑ +26% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,508.40 | ↑ +26% |
| AMERIHEALTH | LOCAL HMO | $4,586.90 | ↑ +28% |
| QUALCARE | WORKERS COMP | $4,667.52 | ↑ +30% |
| CIGNA | HMO | $5,031.00 | ↑ +40% |
| AMERIHEALTH | REGIONAL HMO | $5,195.27 | ↑ +45% |
| CIGNA | PPO | $5,639.00 | ↑ +57% |
| QUALCARE | HMO | $6,256.00 | ↑ +74% |
| AETNA | PPO | $8,419.00 | ↑ +134% |
| AETNA | HMO | $8,419.00 | ↑ +134% |
| HORIZON | WORKERS COMP | $10,715.00 | ↑ +198% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $15,984.00 | ↑ +345% |
| OXFORD | ALL PRODUCTS | $18,636.00 | ↑ +419% |
| UNITED HEALTHCARE | HMO | $23,258.00 | ↑ +548% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $3,591.33 | $3,591.33 – $15,984.00 |
| Hackensack University Medical Center | Hackensack | $3,821.05 | $1,477.52 – $4,012.10 |
| Ocean University Medical Center | Brick | $3,545.97 | $1,427.13 – $15,984.00 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $3,594.44 | $572.02 – $3,594.44 |
| Jersey Shore University Medical Center | Neptune City | $3,591.33 | $1,427.13 – $4,309.59 |
| Palisades Medical Center | North Bergen | $3,821.05 | $1,477.52 – $15,984.00 |
| Raritan Bay Medical Center | Perth Amboy | $3,594.44 | $1,477.52 – $15,984.00 |
| Southern Ocean Medical Center | Manahawkin | $3,545.97 | $1,427.13 – $15,984.00 |