Biliary endo perq dx w/speci 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.
$7,519.00
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.
$198.44 with Horizon Blue Cross Blue Shield of New Jersey vs $13,570.41 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 | $198.44 | ↓ -95% |
| United Healthcare | Community Plan | $933.10 | ↓ -75% |
| Fidelis Care | NJ Family Care | $950.40 | ↓ -75% |
| Aetna | Better Health | $1,021.08 | ↓ -73% |
| Cigna | Local Plus | $2,677.00 | ↓ -29% |
| Wellpoint | NJ Family Care | $3,266.00 | ↓ -14% |
| Cigna | HMO | $3,401.00 | ↓ -10% |
| Cigna | PPO | $3,582.00 | ↓ -5% |
| Qualcare Inc | HMO/POS | $3,617.00 | ↓ -4% |
| First Health | Commercial | $4,511.40 | ↑ +19% |
| United Healthcare | Oxford Metro | $4,791.00 | ↑ +27% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $4,883.59 | ↑ +29% |
| Aetna | HMO | $5,009.00 | ↑ +32% |
| Aetna | PPO | $5,009.00 | ↑ +32% |
| United Healthcare | Nexus | $5,390.00 | ↑ +42% |
| Amerihealth | Local Value | $5,508.41 | ↑ +45% |
| United Healthcare | Oxford Commercial | $5,637.00 | ↑ +49% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $5,639.25 | ↑ +49% |
| Qualcare Inc | PPO/WC | $5,684.36 | ↑ +50% |
| Amerihealth | Regional Preferred | $5,882.86 | ↑ +55% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $5,920.46 | ↑ +56% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $6,017.45 | ↑ +59% |
| United Healthcare | Commercial | $6,341.00 | ↑ +67% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $6,391.15 | ↑ +69% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $6,819.30 | ↑ +80% |
| Aetna | Medicare | $6,819.30 | ↑ +80% |
| Fidelis Care | Medicare Advantage | $6,819.30 | ↑ +80% |
| Humana | Medicare | $6,819.30 | ↑ +80% |
| Clover Health | Medicare Advantage | $6,819.30 | ↑ +80% |
| Wellpoint | Medicare Advantage | $6,819.30 | ↑ +80% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $6,879.13 | ↑ +82% |
| United Healthcare | Medicare | $6,955.69 | ↑ +84% |
| Emblem Health | Commercial | $11,933.78 | ↑ +215% |
| Wellcare | Ambetter Health Commercial | $13,570.41 | ↑ +258% |
Visitor-reported prices
Comments
Biliary endo perq dx w/speci at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $136.27 – $13,638.60 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $198.44 – $14,001.00 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $198.44 – $13,931.00 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $140.28 – $14,001.00 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $176.35 – $14,623.12 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $198.44 – $13,743.99 |
| Bayshore Medical Center | Holmdel | $6,906.53 | $6,906.53 – $8,287.84 |
| Hackensack University Medical Center | Hackensack | $7,348.30 | $179.89 – $8,748.99 |