Diagnostic radio unlisted proc at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$15.55
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.
$75.00
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.
$7.50 with Horizon Blue Cross Blue Shield of New Jersey vs $430.42 with Cigna — 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 | $7.50 | ↓ -52% |
| United Healthcare | Community Plan | $9.30 | ↓ -40% |
| Fidelis Care | NJ Family Care | $9.48 | ↓ -39% |
| Aetna | Better Health | $10.18 | ↓ -35% |
| Aetna | HMO | $41.25 | ↑ +165% |
| Aetna | PPO | $41.25 | ↑ +165% |
| Wellpoint | NJ Family Care | $42.75 | ↑ +175% |
| First Health | Commercial | $45.00 | ↑ +189% |
| Qualcare Inc | HMO/POS | $50.02 | ↑ +222% |
| Qualcare Inc | PPO/WC | $53.32 | ↑ +243% |
| Amerihealth | Regional Preferred | $55.87 | ↑ +259% |
| Amerihealth | Local Value | $55.87 | ↑ +259% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $63.75 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $68.61 | ↑ +341% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $96.23 | ↑ +519% |
| Wellpoint | Medicare Advantage | $96.23 | ↑ +519% |
| Clover Health | Medicare Advantage | $96.23 | ↑ +519% |
| Fidelis Care | Medicare Advantage | $96.23 | ↑ +519% |
| Humana | Medicare | $96.23 | ↑ +519% |
| Aetna | Medicare | $96.23 | ↑ +519% |
| United Healthcare | Medicare | $98.15 | ↑ +531% |
| United Healthcare | Oxford Metro | $116.42 | ↑ +649% |
| United Healthcare | Nexus | $116.42 | ↑ +649% |
| United Healthcare | Oxford Commercial | $126.10 | ↑ +711% |
| United Healthcare | Commercial | $126.10 | ↑ +711% |
| Emblem Health | Commercial | $168.40 | ↑ +983% |
| Wellcare | Ambetter Health Commercial | $191.50 | ↑ +1132% |
| Cigna | Local Plus | $430.42 | ↑ +2668% |
| Cigna | HMO | $430.42 | ↑ +2668% |
| Cigna | PPO | $430.42 | ↑ +2668% |
Visitor-reported prices
Comments
Diagnostic radio unlisted proc at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bayshore Medical Center | Holmdel | $97.46 | $68.21 – $5,610.00 |
| Hackensack University Medical Center | Hackensack | $103.69 | $82.95 – $250.18 |
| Ocean University Medical Center | Brick | $96.23 | $68.21 – $5,610.00 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $97.54 | $88.05 – $231.98 |
| Jersey Shore University Medical Center | Neptune City | $97.46 | $68.21 – $106.23 |
| Palisades Medical Center | North Bergen | $103.69 | $103.69 – $219.04 |
| Raritan Bay Medical Center | Perth Amboy | $97.54 | $68.21 – $219.04 |
| Riverview Medical Center | Red Bank | $97.46 | $68.21 – $5,610.00 |