Biopsy of salivary gland 42400 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.
$2,746.00
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.
$49.98 with Horizon Blue Cross Blue Shield of New Jersey vs $4,174.00 with Aetna — 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 | $49.98 | ↓ -99% |
| United Healthcare | Community Plan | $340.77 | ↓ -91% |
| Fidelis Care | NJ Family Care | $347.09 | ↓ -91% |
| Aetna | Better Health | $372.90 | ↓ -90% |
| Clover Health | Medicare Advantage | $768.94 | ↓ -80% |
| Humana | Medicare | $768.94 | ↓ -80% |
| Wellpoint | Medicare Advantage | $768.94 | ↓ -80% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $768.94 | ↓ -80% |
| Fidelis Care | Medicare Advantage | $768.94 | ↓ -80% |
| Aetna | Medicare | $768.94 | ↓ -80% |
| United Healthcare | Medicare | $784.32 | ↓ -79% |
| Emblem Health | Commercial | $1,345.65 | ↓ -64% |
| Wellcare | Ambetter Health Commercial | $1,530.19 | ↓ -60% |
| First Health | Commercial | $1,647.60 | ↓ -56% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $1,783.52 | ↓ -53% |
| Amerihealth | Local Value | $2,011.71 | ↓ -47% |
| Cigna | Local Plus | $2,033.00 | ↓ -46% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $2,059.50 | ↓ -46% |
| Qualcare Inc | PPO/WC | $2,075.97 | ↓ -45% |
| Amerihealth | Regional Preferred | $2,148.47 | ↓ -43% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $2,162.20 | ↓ -43% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $2,197.62 | ↓ -42% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $2,334.10 | ↓ -38% |
| United Healthcare | Oxford Metro | $2,494.00 | ↓ -34% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $2,512.31 | ↓ -34% |
| Cigna | HMO | $2,583.00 | ↓ -32% |
| Qualcare Inc | HMO/POS | $2,699.00 | ↓ -29% |
| Cigna | PPO | $2,721.00 | ↓ -28% |
| United Healthcare | Nexus | $2,806.00 | ↓ -26% |
| United Healthcare | Oxford Commercial | $2,934.00 | ↓ -23% |
| Wellpoint | NJ Family Care | $3,266.00 | ↓ -14% |
| United Healthcare | Commercial | $3,301.00 | ↓ -13% |
| Aetna | HMO | $4,174.00 | ↑ +10% |
| Aetna | PPO | $4,174.00 | ↑ +10% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $49.52 – $1,537.88 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $48.80 – $1,578.74 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $48.22 – $1,570.85 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $50.98 – $1,578.74 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $52.92 – $1,648.89 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $96.43 – $1,549.77 |
| Bayshore Medical Center | Holmdel | $778.78 | $778.78 – $934.53 |
| Hackensack University Medical Center | Hackensack | $828.59 | $113.25 – $870.02 |