Interrog evl pm/ldls pm ip at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$55.58
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.
$268.00
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.
$33.25 with United Healthcare vs $245.19 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 | $33.25 | ↓ -40% |
| Fidelis Care | NJ Family Care | $33.87 | ↓ -39% |
| Aetna | Better Health | $36.39 | ↓ -35% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $36.58 | ↓ -34% |
| Clover Health | Medicare Advantage | $40.75 | ↓ -27% |
| Humana | Medicare | $40.75 | ↓ -27% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $40.75 | ↓ -27% |
| Aetna | Medicare | $40.75 | ↓ -27% |
| Fidelis Care | Medicare Advantage | $40.75 | ↓ -27% |
| Wellpoint | Medicare Advantage | $40.75 | ↓ -27% |
| United Healthcare | Medicare | $41.57 | ↓ -25% |
| Emblem Health | Commercial | $71.31 | ↑ +28% |
| United Healthcare | Oxford Metro | $77.18 | ↑ +39% |
| United Healthcare | Nexus | $77.18 | ↑ +39% |
| Wellcare | Ambetter Health Commercial | $81.09 | ↑ +46% |
| United Healthcare | Oxford Commercial | $90.58 | ↑ +63% |
| United Healthcare | Commercial | $90.58 | ↑ +63% |
| Aetna | HMO | $147.40 | ↑ +165% |
| Aetna | PPO | $147.40 | ↑ +165% |
| Wellpoint | NJ Family Care | $152.76 | ↑ +175% |
| Cigna | Local Plus | $159.19 | ↑ +186% |
| First Health | Commercial | $160.80 | ↑ +189% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $174.06 | ↑ +213% |
| Qualcare Inc | HMO/POS | $178.75 | ↑ +222% |
| Qualcare Inc | PPO/WC | $190.54 | ↑ +243% |
| Amerihealth | Local Value | $199.66 | ↑ +259% |
| Amerihealth | Regional Preferred | $199.66 | ↑ +259% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $201.00 | ↑ +262% |
| Cigna | HMO | $202.28 | ↑ +264% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $211.02 | ↑ +280% |
| Cigna | PPO | $213.06 | ↑ +283% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $214.48 | ↑ +286% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $227.80 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $245.19 | ↑ +341% |
Visitor-reported prices
Comments
Interrog evl pm/ldls pm ip at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $50.30 | $29.03 – $81.50 |
| Newark Beth Israel Medical Center | Newark | $49.78 | $29.88 – $83.68 |
| Jersey City Medical Center | Jersey City | $55.69 | $37.57 – $87.38 |
| Bayshore Medical Center | Holmdel | $41.27 | $41.27 – $49.53 |
| Hackensack University Medical Center | Hackensack | $43.91 | $35.13 – $2,033.00 |
| Ocean University Medical Center | Brick | $40.75 | $37.29 – $94.86 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $41.31 | $37.29 – $1,042.00 |
| Jersey Shore University Medical Center | Neptune City | $41.27 | $41.27 – $94.86 |