Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular 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.
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What you pay up front if you don't use insurance.
$42,168.00
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.
$496.93 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
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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 | $496.93 | ↓ -87% |
| Wellpoint | NJ Family Care | $3,266.00 | ↓ -14% |
| Qualcare Inc | HMO/POS | $4,148.00 | ↑ +10% |
| United Healthcare | Community Plan | $5,233.04 | ↑ +38% |
| Fidelis Care | NJ Family Care | $5,330.03 | ↑ +41% |
| Aetna | Better Health | $5,726.41 | ↑ +51% |
| United Healthcare | Oxford Metro | $8,505.00 | ↑ +125% |
| Aetna | HMO | $9,184.00 | ↑ +143% |
| Aetna | PPO | $9,184.00 | ↑ +143% |
| United Healthcare | Nexus | $9,568.00 | ↑ +153% |
| United Healthcare | Oxford Commercial | $10,006.00 | ↑ +164% |
| United Healthcare | Commercial | $11,257.00 | ↑ +197% |
| Fidelis Care | Medicare Advantage | $11,437.35 | ↑ +202% |
| Humana | Medicare | $11,437.35 | ↑ +202% |
| Aetna | Medicare | $11,437.35 | ↑ +202% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $11,437.35 | ↑ +202% |
| Wellpoint | Medicare Advantage | $11,437.35 | ↑ +202% |
| Clover Health | Medicare Advantage | $11,437.35 | ↑ +202% |
| United Healthcare | Medicare | $11,666.10 | ↑ +208% |
| Cigna | Local Plus | $18,823.00 | ↑ +397% |
| Emblem Health | Commercial | $20,015.36 | ↑ +429% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $21,036.00 | ↑ +456% |
| Wellcare | Ambetter Health Commercial | $22,760.33 | ↑ +501% |
| 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% |
| First Health | Commercial | $25,300.80 | ↑ +568% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $34,444.00 | ↑ +810% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $40,747.00 | ↑ +976% |
| 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 | PPO/WC | not published by hospital | — |
| Amerihealth | Regional Preferred | not published by hospital | — |
| Amerihealth | Local Value | not published by hospital | — |
Visitor-reported prices
Comments
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $5,855.00 | $257.81 – $22,874.70 |
| Cooperman Barnabas Medical Center | Livingston | $6,839.00 | $485.23 – $23,482.52 |
| Clara Maass Medical Center | Belleville | $3,986.00 | $479.39 – $23,365.11 |
| Newark Beth Israel Medical Center | Newark | $4,881.00 | $265.39 – $23,482.52 |
| Jersey City Medical Center | Jersey City | $5,339.00 | $333.63 – $24,525.95 |
| Monmouth Medical Center | Long Branch | $5,419.00 | $958.78 – $23,051.48 |
| Bayshore Medical Center | Holmdel | $11,583.66 | $11,583.66 – $13,900.39 |
| Hackensack University Medical Center | Hackensack | $12,324.60 | $1,075.73 – $12,940.83 |