Open periprosthetic breast capsule 19370 at Riverview Medical Center
1 Riverview Plaza, Red Bank, NJ · Hackensack Meridian Health · · NPI 1710499462
$4,238.48
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.
$7,563.00
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.
$1,066.38 with AETNA vs $14,048.00 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 | $1,066.38 | ↓ -75% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -72% |
| CLOVER | MEDICARE ADVANTAGE | $1,361.34 | ↓ -68% |
| KARNA | MEDICARE ADVANTAGE | $1,402.24 | ↓ -67% |
| AETNA | MEDICARE ADVANTAGE | $1,588.23 | ↓ -63% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,641.17 | ↓ -61% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,648.73 | ↓ -61% |
| HORIZON | MANAGED MEDICAID | $1,892.00 | ↓ -55% |
| VACCN | ALL PRODUCTS | $4,238.48 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $4,238.48 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $4,238.48 | ↑ +0% |
| CIGNA | HMO | $4,418.00 | ↑ +4% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $4,450.40 | ↑ +5% |
| HORIZON | OMNIA | $4,823.68 | ↑ +14% |
| CIGNA | PPO | $4,950.00 | ↑ +17% |
| UNITED HEALTHCARE | DSNP | $5,086.17 | ↑ +20% |
| BERGEN RISK | ALL PRODUCTS | $5,672.25 | ↑ +34% |
| HORIZON | SHP | $5,819.73 | ↑ +37% |
| QUALCARE | PPO | $5,876.45 | ↑ +39% |
| AETNA | ASA | $5,921.83 | ↑ +40% |
| HORIZON | HMO | $5,966.45 | ↑ +41% |
| HORIZON | PIP | $5,967.21 | ↑ +41% |
| CIGNA | BH | $6,050.40 | ↑ +43% |
| HORIZON | INDEMNITY | $6,052.67 | ↑ +43% |
| HORIZON | PPO | $6,105.61 | ↑ +44% |
| QUALCARE | HMO | $6,256.00 | ↑ +48% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $6,428.55 | ↑ +52% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $6,428.55 | ↑ +52% |
| AMERIHEALTH | LOCAL HMO | $6,540.48 | ↑ +54% |
| QUALCARE | WORKERS COMP | $6,655.44 | ↑ +57% |
| AMERIHEALTH | REGIONAL HMO | $7,407.96 | ↑ +75% |
| AETNA | HMO | $8,419.00 | ↑ +99% |
| AETNA | PPO | $8,419.00 | ↑ +99% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +134% |
| HORIZON | WORKERS COMP | $10,715.00 | ↑ +153% |
| OXFORD | ALL PRODUCTS | $11,277.00 | ↑ +166% |
| UNITED HEALTHCARE | HMO | $14,048.00 | ↑ +231% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Open periprosthetic breast capsule 19370 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $345.00 – $8,369.88 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $331.17 – $8,592.30 |
| Community Medical Center | Toms River | $3,786.00 | $339.15 – $8,328.03 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $327.18 – $8,549.34 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $355.15 – $8,592.30 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $359.10 – $8,974.08 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $654.36 – $8,434.58 |
| Bayshore Medical Center | Holmdel | $4,238.48 | $4,238.48 – $5,086.17 |