ER Visit (level 5, high severity) at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$903.64
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.
$4,357.00
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.
$540.70 with United Healthcare vs $3,976.63 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 | Community Plan | $540.70 | ↓ -40% |
| Fidelis Care | NJ Family Care | $550.72 | ↓ -39% |
| Aetna | Better Health | $591.68 | ↓ -35% |
| Wellpoint | NJ Family Care | $620.00 | ↓ -31% |
| Clover Health | Medicare Advantage | $670.04 | ↓ -26% |
| Fidelis Care | Medicare Advantage | $670.04 | ↓ -26% |
| Humana | Medicare | $670.04 | ↓ -26% |
| Aetna | Medicare | $670.04 | ↓ -26% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $670.04 | ↓ -26% |
| Wellpoint | Medicare Advantage | $670.04 | ↓ -26% |
| United Healthcare | Medicare | $683.44 | ↓ -24% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $780.00 | ↓ -14% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $1,156.00 | ↑ +28% |
| Emblem Health | Commercial | $1,273.00 | ↑ +41% |
| Wellcare | Ambetter Health Commercial | $1,333.38 | ↑ +48% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $1,377.00 | ↑ +52% |
| Qualcare Inc | HMO/POS | $1,387.00 | ↑ +53% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $1,630.00 | ↑ +80% |
| United Healthcare | Oxford Metro | $1,652.00 | ↑ +83% |
| United Healthcare | Nexus | $1,858.00 | ↑ +106% |
| Amerihealth | Local Value | $1,916.00 | ↑ +112% |
| United Healthcare | Oxford Commercial | $1,943.00 | ↑ +115% |
| Cigna | Local Plus | $1,976.00 | ↑ +119% |
| Amerihealth | Regional Preferred | $2,153.00 | ↑ +138% |
| United Healthcare | Commercial | $2,186.00 | ↑ +142% |
| Cigna | HMO | $2,511.00 | ↑ +178% |
| Aetna | HMO | $2,564.00 | ↑ +184% |
| Aetna | PPO | $2,564.00 | ↑ +184% |
| First Health | Commercial | $2,614.20 | ↑ +189% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $2,632.00 | ↑ +191% |
| Cigna | PPO | $2,645.00 | ↑ +193% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $2,675.00 | ↑ +196% |
| Qualcare Inc | PPO/WC | $3,097.82 | ↑ +243% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $3,976.63 | ↑ +340% |
Visitor-reported prices
Comments
ER Visit (level 5, high severity) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $817.80 | $90.41 – $1,862.00 |
| Cooperman Barnabas Medical Center | Livingston | $967.11 | $687.85 – $2,179.00 |
| Clara Maass Medical Center | Belleville | $769.94 | $687.85 – $1,465.00 |
| Newark Beth Israel Medical Center | Newark | $950.68 | $93.07 – $1,485.00 |
| Jersey City Medical Center | Jersey City | $905.38 | $117.00 – $1,605.00 |
| Monmouth Medical Center | Long Branch | $953.31 | $678.62 – $1,715.00 |
| Bayshore Medical Center | Holmdel | $678.62 | $678.62 – $1,787.00 |
| Hackensack University Medical Center | Hackensack | $722.02 | $290.51 – $1,944.00 |