Arthrd glenohumeral jt w/grf at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$3,786.00
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.
not published by hospital
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.
$994.50 with Horizon Blue Cross Blue Shield of New Jersey vs $27,983.16 with Wellcare — 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 Blue Cross Blue Shield of New Jersey | NJ Health | $994.50 | ↓ -74% |
| Wellpoint | NJ Family Care | $3,266.00 | ↓ -14% |
| United Healthcare | Oxford Metro | $7,099.00 | ↑ +88% |
| Cigna | Local Plus | $7,491.00 | ↑ +98% |
| United Healthcare | Nexus | $7,987.00 | ↑ +111% |
| Qualcare Inc | HMO/POS | $8,081.00 | ↑ +113% |
| United Healthcare | Oxford Commercial | $8,352.00 | ↑ +121% |
| Aetna | PPO | $9,184.00 | ↑ +143% |
| Aetna | HMO | $9,184.00 | ↑ +143% |
| United Healthcare | Commercial | $9,396.00 | ↑ +148% |
| Cigna | HMO | $9,518.00 | ↑ +151% |
| Cigna | PPO | $10,025.00 | ↑ +165% |
| Aetna | Medicare | $14,061.89 | ↑ +271% |
| Humana | Medicare | $14,061.89 | ↑ +271% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $14,061.89 | ↑ +271% |
| Clover Health | Medicare Advantage | $14,061.89 | ↑ +271% |
| Fidelis Care | Medicare Advantage | $14,061.89 | ↑ +271% |
| Wellpoint | Medicare Advantage | $14,061.89 | ↑ +271% |
| United Healthcare | Medicare | $14,343.13 | ↑ +279% |
| Emblem Health | Commercial | $24,608.31 | ↑ +550% |
| Wellcare | Ambetter Health Commercial | $27,983.16 | ↑ +639% |
| First Health | Commercial | not published by hospital | — |
| Aetna | Better Health | not published by hospital | — |
| Fidelis Care | NJ Family Care | not published by hospital | — |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | not published by hospital | — |
| Amerihealth | Regional Preferred | not published by hospital | — |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | not published by hospital | — |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | not published by hospital | — |
| Amerihealth | Local Value | not published by hospital | — |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | not published by hospital | — |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | not published by hospital | — |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | not published by hospital | — |
| United Healthcare | Community Plan | not published by hospital | — |
| Qualcare Inc | PPO/WC | not published by hospital | — |
Visitor-reported prices
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Arthrd glenohumeral jt w/grf at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $658.98 – $28,123.78 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $971.10 – $28,871.08 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $959.40 – $28,726.72 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $678.36 – $28,871.08 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $852.80 – $30,153.95 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $1,918.80 – $28,341.12 |
| Bayshore Medical Center | Holmdel | $14,241.77 | $14,241.77 – $17,090.12 |
| Hackensack University Medical Center | Hackensack | $15,152.74 | $2,765.86 – $15,910.38 |