Lower Back (Lumbar Spine) MRI (with and without contrast) at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$1,007.75
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.
$4,859.00
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.
$326.00 with Cigna vs $4,445.49 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 |
|---|---|---|---|
| Cigna | Local Plus | $326.00 | ↓ -68% |
| Humana | Medicare | $390.30 | ↓ -61% |
| Clover Health | Medicare Advantage | $390.30 | ↓ -61% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $390.30 | ↓ -61% |
| Aetna | Medicare | $390.30 | ↓ -61% |
| Fidelis Care | Medicare Advantage | $390.30 | ↓ -61% |
| Wellpoint | Medicare Advantage | $390.30 | ↓ -61% |
| United Healthcare | Medicare | $398.11 | ↓ -60% |
| Cigna | HMO | $414.00 | ↓ -59% |
| Cigna | PPO | $436.00 | ↓ -57% |
| United Healthcare | Nexus | $493.70 | ↓ -51% |
| United Healthcare | Oxford Metro | $493.70 | ↓ -51% |
| Aetna | HMO | $553.12 | ↓ -45% |
| Aetna | PPO | $553.12 | ↓ -45% |
| United Healthcare | Community Plan | $603.00 | ↓ -40% |
| United Healthcare | Oxford Commercial | $603.32 | ↓ -40% |
| United Healthcare | Commercial | $603.32 | ↓ -40% |
| Fidelis Care | NJ Family Care | $614.17 | ↓ -39% |
| Aetna | Better Health | $659.85 | ↓ -35% |
| Emblem Health | Commercial | $683.03 | ↓ -32% |
| Wellcare | Ambetter Health Commercial | $776.70 | ↓ -23% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $892.31 | ↓ -11% |
| Amerihealth | Regional Preferred | $1,076.87 | ↑ +7% |
| Amerihealth | Local Value | $1,076.87 | ↑ +7% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $1,096.67 | ↑ +9% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $1,096.67 | ↑ +9% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $1,096.67 | ↑ +9% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $1,096.67 | ↑ +9% |
| Qualcare Inc | HMO/POS | $2,072.00 | ↑ +106% |
| Qualcare Inc | PPO/WC | $2,166.00 | ↑ +115% |
| Wellpoint | NJ Family Care | $2,769.63 | ↑ +175% |
| First Health | Commercial | $2,915.40 | ↑ +189% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $4,130.15 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $4,445.49 | ↑ +341% |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) MRI (with and without contrast) at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $912.03 | $170.42 – $1,452.87 |
| Cooperman Barnabas Medical Center | Livingston | $1,029.62 | $400.67 – $2,072.00 |
| Clara Maass Medical Center | Belleville | $966.45 | $326.00 – $2,072.00 |
| Newark Beth Israel Medical Center | Newark | $1,012.12 | $175.43 – $2,072.00 |
| Jersey City Medical Center | Jersey City | $1,009.70 | $220.55 – $2,010.00 |
| Monmouth Medical Center | Long Branch | $1,063.14 | $326.00 – $2,072.00 |
| Bayshore Medical Center | Holmdel | $395.29 | $395.29 – $4,332.00 |
| Hackensack University Medical Center | Hackensack | $420.58 | $336.46 – $4,332.00 |