Athrectomy fem/pop/unilateral 37225 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.
$24,943.00
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.
$3,095.42 with United Healthcare vs $39,052.83 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 |
|---|---|---|---|
| United Healthcare | Community Plan | $3,095.42 | ↓ -18% |
| Fidelis Care | NJ Family Care | $3,152.79 | ↓ -17% |
| Wellpoint | NJ Family Care | $3,266.00 | ↓ -14% |
| Aetna | Better Health | $3,387.25 | ↓ -11% |
| Qualcare Inc | HMO/POS | $4,148.00 | ↑ +10% |
| Aetna | PPO | $6,680.00 | ↑ +76% |
| Aetna | HMO | $6,680.00 | ↑ +76% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $8,200.46 | ↑ +117% |
| United Healthcare | Oxford Metro | $8,822.00 | ↑ +133% |
| United Healthcare | Nexus | $9,925.00 | ↑ +162% |
| United Healthcare | Oxford Commercial | $10,379.00 | ↑ +174% |
| United Healthcare | Commercial | $11,677.00 | ↑ +208% |
| Cigna | Local Plus | $12,052.45 | ↑ +218% |
| First Health | Commercial | $14,965.80 | ↑ +295% |
| Cigna | HMO | $15,315.00 | ↑ +305% |
| Cigna | PPO | $16,130.63 | ↑ +326% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $16,200.47 | ↑ +328% |
| Amerihealth | Local Value | $18,273.24 | ↑ +383% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $18,707.25 | ↑ +394% |
| Qualcare Inc | PPO/WC | $18,856.90 | ↑ +398% |
| Amerihealth | Regional Preferred | $19,515.40 | ↑ +415% |
| Humana | Medicare | $19,624.54 | ↑ +418% |
| Fidelis Care | Medicare Advantage | $19,624.54 | ↑ +418% |
| Clover Health | Medicare Advantage | $19,624.54 | ↑ +418% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $19,624.54 | ↑ +418% |
| Aetna | Medicare | $19,624.54 | ↑ +418% |
| Wellpoint | Medicare Advantage | $19,624.54 | ↑ +418% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $19,640.11 | ↑ +419% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $19,961.88 | ↑ +427% |
| United Healthcare | Medicare | $20,017.03 | ↑ +429% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $21,201.55 | ↑ +460% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $22,820.35 | ↑ +503% |
| Emblem Health | Commercial | $34,342.95 | ↑ +807% |
| Wellcare | Ambetter Health Commercial | $39,052.83 | ↑ +932% |
Visitor-reported prices
Comments
Athrectomy fem/pop/unilateral 37225 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $4,490.69 – $39,249.08 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $8,007.51 – $40,292.00 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $7,911.03 – $40,090.54 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $4,622.77 – $40,292.00 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $5,811.48 – $42,082.35 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $15,822.06 – $39,552.40 |
| Bayshore Medical Center | Holmdel | $19,875.58 | $19,875.58 – $23,850.69 |
| Hackensack University Medical Center | Hackensack | $21,146.91 | $1,210.96 – $22,204.26 |