Established Patient Office Visit (level 2) at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$96.44
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.
$465.00
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.
$49.06 with Horizon Blue Cross Blue Shield of New Jersey vs $425.42 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 |
|---|---|---|---|
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $49.06 | ↓ -49% |
| United Healthcare | Community Plan | $57.70 | ↓ -40% |
| Fidelis Care | NJ Family Care | $58.77 | ↓ -39% |
| Aetna | Better Health | $63.14 | ↓ -35% |
| United Healthcare | Oxford Metro | $133.92 | ↑ +39% |
| United Healthcare | Nexus | $133.92 | ↑ +39% |
| United Healthcare | Commercial | $157.17 | ↑ +63% |
| United Healthcare | Oxford Commercial | $157.17 | ↑ +63% |
| Aetna | PPO | $255.75 | ↑ +165% |
| Aetna | HMO | $255.75 | ↑ +165% |
| Wellpoint | NJ Family Care | $265.05 | ↑ +175% |
| Cigna | Local Plus | $276.21 | ↑ +186% |
| First Health | Commercial | $279.00 | ↑ +189% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $302.01 | ↑ +213% |
| Qualcare Inc | HMO/POS | $310.15 | ↑ +222% |
| Qualcare Inc | PPO/WC | $330.61 | ↑ +243% |
| Amerihealth | Local Value | $346.42 | ↑ +259% |
| Amerihealth | Regional Preferred | $346.42 | ↑ +259% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $348.75 | ↑ +262% |
| Cigna | HMO | $350.98 | ↑ +264% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $366.14 | ↑ +280% |
| Cigna | PPO | $369.67 | ↑ +283% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $372.13 | ↑ +286% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $395.25 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $425.42 | ↑ +341% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 2) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $87.28 | $30.25 – $49.06 |
| Cooperman Barnabas Medical Center | Livingston | $98.53 | $49.06 – $49.06 |
| Clara Maass Medical Center | Belleville | $92.48 | $49.06 – $49.06 |
| Childrens Specialized Hospital | Mountainside | $159.00 | $134.16 – $134.16 |
| Newark Beth Israel Medical Center | Newark | $96.85 | $31.14 – $49.06 |
| Jersey City Medical Center | Jersey City | $96.62 | $39.15 – $49.06 |
| Monmouth Medical Center | Long Branch | $101.74 | $49.06 – $49.06 |
| Robert Wood Johnson University Hospital Hamilton | Hamilton Township | $76.21 | $49.06 – $49.06 |