ER Visit (level 1, minor) at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$218.18
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.
?
What you pay up front if you don't use insurance.
$1,052.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$96.23 with Clover Health vs $2,675.00 with Horizon Blue Cross Blue Shield of New Jersey — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Clover Health | Medicare Advantage | $96.23 | ↓ -56% |
| Humana | Medicare | $96.23 | ↓ -56% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $96.23 | ↓ -56% |
| Fidelis Care | Medicare Advantage | $96.23 | ↓ -56% |
| Wellpoint | Medicare Advantage | $96.23 | ↓ -56% |
| Aetna | Medicare | $96.23 | ↓ -56% |
| United Healthcare | Medicare | $98.15 | ↓ -55% |
| United Healthcare | Community Plan | $130.55 | ↓ -40% |
| Fidelis Care | NJ Family Care | $132.97 | ↓ -39% |
| Aetna | Better Health | $142.86 | ↓ -35% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $143.00 | ↓ -34% |
| Wellcare | Ambetter Health Commercial | $191.50 | ↓ -12% |
| Cigna | Local Plus | $315.00 | ↑ +44% |
| Emblem Health | Commercial | $345.00 | ↑ +58% |
| Cigna | HMO | $400.00 | ↑ +83% |
| Cigna | PPO | $421.00 | ↑ +93% |
| United Healthcare | Oxford Metro | $531.00 | ↑ +143% |
| Aetna | PPO | $597.00 | ↑ +174% |
| Aetna | HMO | $597.00 | ↑ +174% |
| United Healthcare | Nexus | $598.00 | ↑ +174% |
| Wellpoint | NJ Family Care | $620.00 | ↑ +184% |
| United Healthcare | Oxford Commercial | $625.00 | ↑ +186% |
| First Health | Commercial | $631.20 | ↑ +189% |
| United Healthcare | Commercial | $703.00 | ↑ +222% |
| Qualcare Inc | PPO/WC | $747.97 | ↑ +243% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $960.16 | ↑ +340% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $1,156.00 | ↑ +430% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $1,377.00 | ↑ +531% |
| Qualcare Inc | HMO/POS | $1,387.00 | ↑ +536% |
| Amerihealth | Local Value | $1,554.00 | ↑ +612% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $1,630.00 | ↑ +647% |
| Amerihealth | Regional Preferred | $1,750.00 | ↑ +702% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $2,632.00 | ↑ +1106% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $2,675.00 | ↑ +1126% |
Visitor-reported prices
Comments
ER Visit (level 1, minor) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $197.46 | $5.69 – $400.00 |
| Cooperman Barnabas Medical Center | Livingston | $222.91 | $98.79 – $1,387.00 |
| Clara Maass Medical Center | Belleville | $181.99 | $98.79 – $1,387.00 |
| Newark Beth Israel Medical Center | Newark | $219.13 | $5.86 – $1,387.00 |
| Jersey City Medical Center | Jersey City | $218.60 | $7.37 – $1,387.00 |
| Monmouth Medical Center | Long Branch | $230.17 | $97.46 – $1,387.00 |
| Bayshore Medical Center | Holmdel | $97.46 | $97.46 – $1,522.00 |
| Hackensack University Medical Center | Hackensack | $103.69 | $19.04 – $1,522.00 |