Excision addl breast lesion 19126 at Riverview Medical Center
1 Riverview Plaza, Red Bank, NJ · Hackensack Meridian Health · · NPI 1710499462
not published by hospital
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.
$4,753.00
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.
$326.32 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 | $326.32 | — |
| AETNA | MANAGED MEDICAID | $670.17 | — |
| CLOVER | MEDICARE ADVANTAGE | $855.54 | — |
| AETNA | MEDICARE ADVANTAGE | $998.13 | — |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,031.40 | — |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,036.15 | — |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | — |
| HORIZON | MANAGED MEDICAID | $1,534.00 | — |
| OXFORD | ALL PRODUCTS | $2,825.00 | — |
| HORIZON | OMNIA | $3,031.46 | — |
| UNITED HEALTHCARE | HMO | $3,473.00 | — |
| BERGEN RISK | ALL PRODUCTS | $3,564.75 | — |
| HORIZON | SHP | $3,657.43 | — |
| QUALCARE | PPO | $3,693.08 | — |
| AETNA | ASA | $3,721.60 | — |
| HORIZON | HMO | $3,749.64 | — |
| HORIZON | PIP | $3,750.12 | — |
| CIGNA | BH | $3,802.40 | — |
| HORIZON | INDEMNITY | $3,803.83 | — |
| HORIZON | PPO | $3,837.10 | — |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $4,040.05 | — |
| MULTIPLAN - PHCS | ALL PRODUCTS | $4,040.05 | — |
| AMERIHEALTH | LOCAL HMO | $4,110.39 | — |
| QUALCARE | WORKERS COMP | $4,182.64 | — |
| AMERIHEALTH | REGIONAL HMO | $4,655.56 | — |
| QUALCARE | HMO | $6,256.00 | — |
| AETNA | PPO | $8,419.00 | — |
| AETNA | HMO | $8,419.00 | — |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | — |
| HORIZON | WORKERS COMP | $10,715.00 | — |
| CIGNA | PPO | not published by hospital | — |
| CIGNA | HMO | not published by hospital | — |
| WELLCARE | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | not published by hospital | — |
| UNITED HEALTHCARE | DSNP | not published by hospital | — |
| VACCN | ALL PRODUCTS | not published by hospital | — |
| WELLCARE | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Excision addl breast lesion 19126 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | not published | not published |
| Hackensack University Medical Center | Hackensack | not published | $333.40 – $333.40 |
| Ocean University Medical Center | Brick | not published | $326.32 – $326.32 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | not published | $156.98 – $333.40 |
| Jersey Shore University Medical Center | Neptune City | not published | $326.32 – $326.32 |
| Palisades Medical Center | North Bergen | not published | $333.40 – $333.40 |
| Raritan Bay Medical Center | Perth Amboy | not published | $333.40 – $333.40 |
| Southern Ocean Medical Center | Manahawkin | not published | $326.32 – $326.32 |