Surgical pathology level 6 gross & microscopic examination at Riverview Medical Center
1 Riverview Plaza, Red Bank, NJ · Hackensack Meridian Health · · NPI 1710499462
$904.19
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.
$1,111.00
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.
$102.35 with HORIZON vs $1,346.75 with OXFORD — 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 |
|---|---|---|---|
| HORIZON | MANAGED MEDICAID | $102.35 | ↓ -89% |
| AETNA | MANAGED MEDICAID | $156.65 | ↓ -83% |
| SEOUL MEDICAL GROUP | ALL PRODUCTS | $241.09 | ↓ -73% |
| UNITED HEALTHCARE | MANAGED MEDICAID | $249.24 | ↓ -72% |
| QUALCARE | HMO | $551.06 | ↓ -39% |
| HORIZON | OMNIA | $708.60 | ↓ -22% |
| AETNA | HMO | $764.37 | ↓ -15% |
| AETNA | PPO | $764.37 | ↓ -15% |
| HORIZON | WORKERS COMP | $782.14 | ↓ -13% |
| BERGEN RISK | ALL PRODUCTS | $833.25 | ↓ -8% |
| HORIZON | SHP | $854.91 | ↓ -5% |
| QUALCARE | PPO | $863.25 | ↓ -5% |
| AETNA | ASA | $869.91 | ↓ -4% |
| HORIZON | HMO | $876.47 | ↓ -3% |
| HORIZON | PIP | $876.58 | ↓ -3% |
| BRIGHTON HEALTH PLAN | ALL PRODUCTS | $888.80 | ↓ -2% |
| CIGNA | BH | $888.80 | ↓ -2% |
| HORIZON | INDEMNITY | $889.13 | ↓ -2% |
| HORIZON | PPO | $896.91 | ↓ -1% |
| VACCN | ALL PRODUCTS | $904.19 | ↑ +0% |
| WELLCARE | MEDICARE ADVANTAGE | $904.19 | ↑ +0% |
| HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $904.19 | ↑ +0% |
| WELLCARE | MANAGED MEDICAID | $904.19 | ↑ +0% |
| MULTIPLAN - PHCS | ALL PRODUCTS | $944.35 | ↑ +4% |
| ACTIVECARE FIRST MCO | ALL PRODUCTS | $944.35 | ↑ +4% |
| UNITED COMMUNITY/AMERICHOICE | MEDICARE ADVANTAGE | $949.40 | ↑ +5% |
| AMERIHEALTH | LOCAL HMO | $960.79 | ↑ +6% |
| QUALCARE | WORKERS COMP | $977.68 | ↑ +8% |
| AETNA | MEDICARE ADVANTAGE | $985.57 | ↑ +9% |
| CIGNA | HMO | $1,062.45 | ↑ +18% |
| CIGNA | PPO | $1,062.45 | ↑ +18% |
| UNITED HEALTHCARE | DSNP | $1,085.03 | ↑ +20% |
| AMERIHEALTH | REGIONAL HMO | $1,088.22 | ↑ +20% |
| UNITED HEALTHCARE | HMO | $1,346.75 | ↑ +49% |
| OXFORD | ALL PRODUCTS | $1,346.75 | ↑ +49% |
| KARNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIGROUP | MANAGED MEDICAID | not published by hospital | — |
| CLOVER | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 6 gross & microscopic examination at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $291.87 | $231.40 – $1,785.54 |
| Cooperman Barnabas Medical Center | Livingston | $278.86 | $145.96 – $1,833.00 |
| Community Medical Center | Toms River | $322.50 | $145.96 – $1,776.61 |
| Clara Maass Medical Center | Belleville | $210.63 | $145.96 – $1,823.84 |
| Newark Beth Israel Medical Center | Newark | $274.12 | $145.96 – $1,833.00 |
| Jersey City Medical Center | Jersey City | $323.12 | $145.96 – $1,914.44 |
| Monmouth Medical Center | Long Branch | $340.23 | $145.96 – $1,799.34 |
| Bayshore Medical Center | Holmdel | $904.19 | $249.24 – $1,346.75 |