Dup scan/ue art/graft/bilat/comp 93930 at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$529.90
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.
$2,555.00
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.
$264.17 with Wellpoint vs $2,452.00 with United Healthcare — 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 |
|---|---|---|---|
| Wellpoint | Medicare Advantage | $264.17 | ↓ -50% |
| Humana | Medicare | $264.17 | ↓ -50% |
| Fidelis Care | Medicare Advantage | $264.17 | ↓ -50% |
| Aetna | Medicare | $264.17 | ↓ -50% |
| Clover Health | Medicare Advantage | $264.17 | ↓ -50% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $264.17 | ↓ -50% |
| United Healthcare | Medicare | $269.45 | ↓ -49% |
| United Healthcare | Community Plan | $317.07 | ↓ -40% |
| Fidelis Care | NJ Family Care | $322.95 | ↓ -39% |
| Aetna | Better Health | $346.96 | ↓ -35% |
| Emblem Health | Commercial | $462.30 | ↓ -13% |
| Wellcare | Ambetter Health Commercial | $525.70 | ↓ -1% |
| Cigna | Local Plus | $836.55 | ↑ +58% |
| Cigna | PPO | $836.55 | ↑ +58% |
| Cigna | HMO | $836.55 | ↑ +58% |
| Aetna | PPO | $1,405.25 | ↑ +165% |
| Aetna | HMO | $1,405.25 | ↑ +165% |
| Wellpoint | NJ Family Care | $1,456.35 | ↑ +175% |
| First Health | Commercial | $1,533.00 | ↑ +189% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $1,659.47 | ↑ +213% |
| Qualcare Inc | HMO/POS | $1,704.18 | ↑ +222% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $1,757.80 | ↑ +232% |
| Qualcare Inc | PPO/WC | $1,816.60 | ↑ +243% |
| Amerihealth | Regional Preferred | $1,903.47 | ↑ +259% |
| Amerihealth | Local Value | $1,903.47 | ↑ +259% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $1,916.25 | ↑ +262% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $2,011.80 | ↑ +280% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $2,044.76 | ↑ +286% |
| United Healthcare | Nexus | $2,084.00 | ↑ +293% |
| United Healthcare | Oxford Metro | $2,084.00 | ↑ +293% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $2,171.75 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $2,337.56 | ↑ +341% |
| United Healthcare | Oxford Commercial | $2,452.00 | ↑ +363% |
| United Healthcare | Commercial | $2,452.00 | ↑ +363% |
Visitor-reported prices
Comments
Dup scan/ue art/graft/bilat/comp 93930 at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $479.57 | $103.35 – $836.55 |
| Cooperman Barnabas Medical Center | Livingston | $547.76 | $271.19 – $836.55 |
| Clara Maass Medical Center | Belleville | $397.20 | $271.19 – $836.55 |
| Newark Beth Israel Medical Center | Newark | $538.45 | $106.39 – $836.55 |
| Jersey City Medical Center | Jersey City | $530.92 | $133.74 – $836.55 |
| Monmouth Medical Center | Long Branch | $559.03 | $267.55 – $836.55 |
| Bayshore Medical Center | Holmdel | $267.55 | $267.55 – $1,207.00 |
| Hackensack University Medical Center | Hackensack | $284.66 | $227.73 – $4,324.00 |