Cllr miami j sm at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$20.81
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.
$100.38
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.
$12.45 with United Healthcare vs $615.87 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 | $12.45 | ↓ -40% |
| Fidelis Care | NJ Family Care | $12.68 | ↓ -39% |
| Aetna | Better Health | $13.63 | ↓ -35% |
| United Healthcare | Commercial | $40.15 | ↑ +93% |
| United Healthcare | Oxford Commercial | $40.15 | ↑ +93% |
| United Healthcare | Oxford Metro | $40.15 | ↑ +93% |
| Amerihealth | Local Value | $40.15 | ↑ +93% |
| Amerihealth | Regional Preferred | $40.15 | ↑ +93% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $40.15 | ↑ +93% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $40.15 | ↑ +93% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $40.15 | ↑ +93% |
| United Healthcare | Nexus | $40.15 | ↑ +93% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $40.15 | ↑ +93% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $40.15 | ↑ +93% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $40.15 | ↑ +93% |
| Cigna | PPO | $40.15 | ↑ +93% |
| Cigna | HMO | $40.15 | ↑ +93% |
| Cigna | Local Plus | $40.15 | ↑ +93% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $40.15 | ↑ +93% |
| Aetna | HMO | $45.17 | ↑ +117% |
| Aetna | PPO | $45.17 | ↑ +117% |
| Qualcare Inc | PPO/WC | $50.19 | ↑ +141% |
| Wellpoint | NJ Family Care | $50.19 | ↑ +141% |
| Qualcare Inc | HMO/POS | $50.19 | ↑ +141% |
| First Health | Commercial | $60.22 | ↑ +189% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $309.48 | ↑ +1387% |
| Clover Health | Medicare Advantage | $309.48 | ↑ +1387% |
| Wellpoint | Medicare Advantage | $309.48 | ↑ +1387% |
| Aetna | Medicare | $309.48 | ↑ +1387% |
| Fidelis Care | Medicare Advantage | $309.48 | ↑ +1387% |
| Humana | Medicare | $309.48 | ↑ +1387% |
| United Healthcare | Medicare | $315.67 | ↑ +1417% |
| Emblem Health | Commercial | $541.59 | ↑ +2503% |
| Wellcare | Ambetter Health Commercial | $615.87 | ↑ +2859% |
Visitor-reported prices
Comments
Cllr miami j sm at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $26.37 | $116.18 – $615.87 |
| Cooperman Barnabas Medical Center | Livingston | $21.27 | $309.48 – $618.96 |
| Clara Maass Medical Center | Belleville | $19.96 | $309.48 – $615.87 |
| Newark Beth Israel Medical Center | Newark | $20.90 | $119.60 – $615.87 |
| Jersey City Medical Center | Jersey City | $20.85 | $150.35 – $615.87 |
| Monmouth Medical Center | Long Branch | $21.96 | $309.48 – $615.87 |
| Robert Wood Johnson University Hospital Hamilton | Hamilton Township | $23.03 | $309.48 – $615.87 |
| Monmouth Medical Center Southern Campus | Lakewood | $23.86 | $309.48 – $615.87 |