Ins/rpl ldless pm right vent w img & eval at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$3,786.00
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.
$35,801.00
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.
$467.02 with Horizon Blue Cross Blue Shield of New Jersey vs $43,541.00 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 |
|---|---|---|---|
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $467.02 | ↓ -88% |
| Wellpoint | NJ Family Care | $3,266.00 | ↓ -14% |
| United Healthcare | Community Plan | $4,442.90 | ↑ +17% |
| Fidelis Care | NJ Family Care | $4,525.24 | ↑ +20% |
| Aetna | Better Health | $4,861.77 | ↑ +28% |
| Aetna | HMO | $6,680.00 | ↑ +76% |
| Aetna | PPO | $6,680.00 | ↑ +76% |
| United Healthcare | Oxford Metro | $8,991.00 | ↑ +137% |
| United Healthcare | Nexus | $10,115.00 | ↑ +167% |
| United Healthcare | Oxford Commercial | $10,578.00 | ↑ +179% |
| United Healthcare | Commercial | $11,900.00 | ↑ +214% |
| Cigna | Local Plus | $18,823.00 | ↑ +397% |
| Aetna | Medicare | $20,842.49 | ↑ +451% |
| Humana | Medicare | $20,842.49 | ↑ +451% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $20,842.49 | ↑ +451% |
| Clover Health | Medicare Advantage | $20,842.49 | ↑ +451% |
| Fidelis Care | Medicare Advantage | $20,842.49 | ↑ +451% |
| Wellpoint | Medicare Advantage | $20,842.49 | ↑ +451% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $21,036.00 | ↑ +456% |
| United Healthcare | Medicare | $21,259.34 | ↑ +462% |
| First Health | Commercial | $21,480.60 | ↑ +467% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $23,032.00 | ↑ +508% |
| Cigna | HMO | $23,917.00 | ↑ +532% |
| Cigna | PPO | $25,191.00 | ↑ +565% |
| Amerihealth | Local Value | $26,671.74 | ↑ +604% |
| Amerihealth | Regional Preferred | $26,671.74 | ↑ +604% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $34,444.00 | ↑ +810% |
| Emblem Health | Commercial | $36,474.36 | ↑ +863% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $40,747.00 | ↑ +976% |
| Wellcare | Ambetter Health Commercial | $41,476.56 | ↑ +996% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $42,840.00 | ↑ +1032% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $43,541.00 | ↑ +1050% |
| Qualcare Inc | HMO/POS | not published by hospital | — |
| Qualcare Inc | PPO/WC | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl ldless pm right vent w img & eval at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $238.10 – $41,684.98 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $456.04 – $42,792.64 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $450.54 – $42,578.68 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $245.10 – $42,792.64 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $308.13 – $44,694.09 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $901.08 – $42,007.11 |
| Bayshore Medical Center | Holmdel | $21,109.10 | $21,109.10 – $25,330.93 |
| Hackensack University Medical Center | Hackensack | $22,459.34 | $993.76 – $23,582.31 |