Consultation pathology during surgery at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$43.55
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.
$210.00
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.
$15.96 with United Healthcare vs $192.12 with Horizon Blue Cross Blue Shield of New Jersey — 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 | Oxford Metro | $15.96 | ↓ -63% |
| United Healthcare | Nexus | $15.96 | ↓ -63% |
| United Healthcare | Oxford Commercial | $18.39 | ↓ -58% |
| United Healthcare | Commercial | $18.39 | ↓ -58% |
| Aetna | Better Health | $28.51 | ↓ -35% |
| Aetna | PPO | $42.49 | ↓ -2% |
| Aetna | HMO | $42.49 | ↓ -2% |
| United Healthcare | Community Plan | $46.53 | ↑ +7% |
| Fidelis Care | NJ Family Care | $47.41 | ↑ +9% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $54.12 | ↑ +24% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $60.77 | ↑ +40% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $60.77 | ↑ +40% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $60.77 | ↑ +40% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $60.77 | ↑ +40% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $64.92 | ↑ +49% |
| Wellpoint | Medicare Advantage | $64.92 | ↑ +49% |
| Clover Health | Medicare Advantage | $64.92 | ↑ +49% |
| Fidelis Care | Medicare Advantage | $64.92 | ↑ +49% |
| Humana | Medicare | $64.92 | ↑ +49% |
| Aetna | Medicare | $64.92 | ↑ +49% |
| Amerihealth | Regional Preferred | $65.74 | ↑ +51% |
| Amerihealth | Local Value | $65.74 | ↑ +51% |
| United Healthcare | Medicare | $66.22 | ↑ +52% |
| Cigna | PPO | $75.02 | ↑ +72% |
| Cigna | HMO | $75.02 | ↑ +72% |
| Cigna | Local Plus | $75.02 | ↑ +72% |
| Emblem Health | Commercial | $113.61 | ↑ +161% |
| Wellpoint | NJ Family Care | $119.70 | ↑ +175% |
| First Health | Commercial | $126.00 | ↑ +189% |
| Wellcare | Ambetter Health Commercial | $129.19 | ↑ +197% |
| Qualcare Inc | HMO/POS | $140.07 | ↑ +222% |
| Qualcare Inc | PPO/WC | $149.31 | ↑ +243% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $178.50 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $192.12 | ↑ +341% |
Visitor-reported prices
Comments
Consultation pathology during surgery at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $39.41 | $15.96 – $129.84 |
| Cooperman Barnabas Medical Center | Livingston | $27.54 | $15.96 – $133.28 |
| Clara Maass Medical Center | Belleville | $29.83 | $15.96 – $132.61 |
| Newark Beth Israel Medical Center | Newark | $27.07 | $15.96 – $133.28 |
| Jersey City Medical Center | Jersey City | $43.63 | $15.96 – $139.20 |
| Bayshore Medical Center | Holmdel | $65.75 | $64.79 – $71.66 |
| Hackensack University Medical Center | Hackensack | $69.95 | $49.06 – $78.15 |
| Ocean University Medical Center | Brick | $64.92 | $36.30 – $69.46 |