Biopsy of toe joint lining 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.
$6,552.00
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.
$490.26 with KARNA vs $10,715.00 with HORIZON — 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 | $490.26 | ↓ -86% |
| AETNA | MANAGED MEDICAID | $923.83 | ↓ -74% |
| CLOVER | MEDICARE ADVANTAGE | $1,179.36 | ↓ -67% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -67% |
| HORIZON | MANAGED MEDICAID | $1,339.00 | ↓ -63% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,421.78 | ↓ -60% |
| CIGNA | HMO | $3,140.00 | ↓ -13% |
| CIGNA | PPO | $3,514.00 | ↓ -2% |
| VACCN | ALL PRODUCTS | $3,591.33 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $3,591.33 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $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% |
| HORIZON | OMNIA | $4,178.87 | ↑ +16% |
| UNITED HEALTHCARE | DSNP | $4,309.59 | ↑ +20% |
| BERGEN RISK | ALL PRODUCTS | $4,914.00 | ↑ +37% |
| HORIZON | SHP | $5,041.76 | ↑ +40% |
| QUALCARE | PPO | $5,090.90 | ↑ +42% |
| AETNA | ASA | $5,130.22 | ↑ +43% |
| HORIZON | HMO | $5,168.87 | ↑ +44% |
| HORIZON | PIP | $5,169.53 | ↑ +44% |
| CIGNA | BH | $5,241.60 | ↑ +46% |
| HORIZON | INDEMNITY | $5,243.57 | ↑ +46% |
| HORIZON | PPO | $5,289.43 | ↑ +47% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $5,569.20 | ↑ +55% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $5,569.20 | ↑ +55% |
| AMERIHEALTH | LOCAL HMO | $5,666.17 | ↑ +58% |
| QUALCARE | WORKERS COMP | $5,765.76 | ↑ +61% |
| QUALCARE | HMO | $6,256.00 | ↑ +74% |
| AMERIHEALTH | REGIONAL HMO | $6,417.68 | ↑ +79% |
| OXFORD | ALL PRODUCTS | $8,268.00 | ↑ +130% |
| AETNA | HMO | $8,419.00 | ↑ +134% |
| AETNA | PPO | $8,419.00 | ↑ +134% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +177% |
| UNITED HEALTHCARE | HMO | $10,284.00 | ↑ +186% |
| HORIZON | WORKERS COMP | $10,715.00 | ↑ +198% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of toe joint lining at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $3,591.33 | $3,591.33 – $4,309.59 |
| Hackensack University Medical Center | Hackensack | $3,821.05 | $508.51 – $4,012.10 |
| Ocean University Medical Center | Brick | $3,545.97 | $490.26 – $4,255.16 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $3,594.44 | $290.84 – $3,594.44 |
| Jersey Shore University Medical Center | Neptune City | $3,591.33 | $490.26 – $4,309.59 |
| Palisades Medical Center | North Bergen | $3,821.05 | $508.51 – $4,164.94 |
| Raritan Bay Medical Center | Perth Amboy | $3,594.44 | $508.51 – $4,313.33 |
| Southern Ocean Medical Center | Manahawkin | $3,545.97 | $490.26 – $4,255.16 |