Repair of tibia epiphysis 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.
$7,830.00
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.
$1,104.03 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 | $1,104.03 | ↓ -69% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $1,189.00 | ↓ -67% |
| KARNA | MEDICARE ADVANTAGE | $1,246.71 | ↓ -65% |
| HORIZON | MANAGED MEDICAID | $1,339.00 | ↓ -63% |
| CLOVER | MEDICARE ADVANTAGE | $1,409.40 | ↓ -61% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $1,699.11 | ↓ -53% |
| 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% |
| UNITED HEALTHCARE | DSNP | $4,309.59 | ↑ +20% |
| HORIZON | OMNIA | $4,993.97 | ↑ +39% |
| BERGEN RISK | ALL PRODUCTS | $5,872.50 | ↑ +64% |
| HORIZON | SHP | $6,025.19 | ↑ +68% |
| QUALCARE | PPO | $6,083.91 | ↑ +69% |
| AETNA | ASA | $6,130.89 | ↑ +71% |
| HORIZON | HMO | $6,177.09 | ↑ +72% |
| HORIZON | PIP | $6,177.87 | ↑ +72% |
| QUALCARE | HMO | $6,256.00 | ↑ +74% |
| CIGNA | BH | $6,264.00 | ↑ +74% |
| HORIZON | INDEMNITY | $6,266.35 | ↑ +74% |
| HORIZON | PPO | $6,321.16 | ↑ +76% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $6,655.50 | ↑ +85% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $6,655.50 | ↑ +85% |
| AMERIHEALTH | LOCAL HMO | $6,771.38 | ↑ +89% |
| QUALCARE | WORKERS COMP | $6,890.40 | ↑ +92% |
| AMERIHEALTH | REGIONAL HMO | $7,669.49 | ↑ +114% |
| AETNA | HMO | $8,419.00 | ↑ +134% |
| AETNA | PPO | $8,419.00 | ↑ +134% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $9,933.00 | ↑ +177% |
| HORIZON | WORKERS COMP | $10,715.00 | ↑ +198% |
| OXFORD | ALL PRODUCTS | $11,277.00 | ↑ +214% |
| UNITED HEALTHCARE | HMO | $14,048.00 | ↑ +291% |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
Repair of tibia epiphysis at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $306.73 – $7,091.94 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $427.25 – $7,280.38 |
| Community Medical Center | Toms River | $3,786.00 | $437.55 – $7,056.48 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $422.10 – $7,243.98 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $315.76 – $7,280.38 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $396.95 – $7,603.89 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $844.21 – $7,146.75 |
| Bayshore Medical Center | Holmdel | $3,591.33 | $3,591.33 – $4,309.59 |