Biliary endoscopy thru skin 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.
$10,160.00
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.
$419.84 with Horizon Blue Cross Blue Shield of New Jersey vs $22,642.64 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 | $419.84 | ↓ -89% |
| United Healthcare | Community Plan | $1,260.85 | ↓ -67% |
| Fidelis Care | NJ Family Care | $1,284.22 | ↓ -66% |
| Aetna | Better Health | $1,379.72 | ↓ -64% |
| Wellpoint | NJ Family Care | $3,266.00 | ↓ -14% |
| Aetna | PPO | $5,845.00 | ↑ +54% |
| Aetna | HMO | $5,845.00 | ↑ +54% |
| First Health | Commercial | $6,096.00 | ↑ +61% |
| Qualcare Inc | HMO/POS | $6,329.68 | ↑ +67% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $6,598.92 | ↑ +74% |
| United Healthcare | Oxford Metro | $7,099.00 | ↑ +88% |
| Amerihealth | Local Value | $7,443.21 | ↑ +97% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $7,620.00 | ↑ +101% |
| Qualcare Inc | PPO/WC | $7,680.96 | ↑ +103% |
| Amerihealth | Regional Preferred | $7,949.18 | ↑ +110% |
| United Healthcare | Nexus | $7,987.00 | ↑ +111% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $7,999.98 | ↑ +111% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $8,131.04 | ↑ +115% |
| United Healthcare | Oxford Commercial | $8,352.00 | ↑ +121% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $8,636.00 | ↑ +128% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $9,295.38 | ↑ +146% |
| United Healthcare | Commercial | $9,396.00 | ↑ +148% |
| Cigna | Local Plus | $9,629.00 | ↑ +154% |
| Fidelis Care | Medicare Advantage | $11,378.21 | ↑ +201% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $11,378.21 | ↑ +201% |
| Clover Health | Medicare Advantage | $11,378.21 | ↑ +201% |
| Wellpoint | Medicare Advantage | $11,378.21 | ↑ +201% |
| Aetna | Medicare | $11,378.21 | ↑ +201% |
| Humana | Medicare | $11,378.21 | ↑ +201% |
| United Healthcare | Medicare | $11,605.77 | ↑ +207% |
| Cigna | HMO | $12,235.00 | ↑ +223% |
| Cigna | PPO | $12,887.00 | ↑ +240% |
| Emblem Health | Commercial | $19,911.87 | ↑ +426% |
| Wellcare | Ambetter Health Commercial | $22,642.64 | ↑ +498% |
Visitor-reported prices
Comments
Biliary endoscopy thru skin at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $183.70 – $22,756.42 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $419.84 – $23,361.12 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $419.84 – $23,244.31 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $189.11 – $23,361.12 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $237.73 – $24,399.15 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $419.84 – $22,932.28 |
| Bayshore Medical Center | Holmdel | $11,523.76 | $11,523.76 – $13,828.52 |
| Hackensack University Medical Center | Hackensack | $12,260.88 | $762.10 – $12,873.92 |