M/phmtrc alys ishquant/semiq at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$85.86
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.
$414.00
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.
$20.86 with United Healthcare vs $378.76 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 | Nexus | $20.86 | ↓ -76% |
| United Healthcare | Oxford Metro | $20.86 | ↓ -76% |
| United Healthcare | Oxford Commercial | $26.00 | ↓ -70% |
| United Healthcare | Commercial | $26.00 | ↓ -70% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $43.57 | ↓ -49% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $49.84 | ↓ -42% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $49.84 | ↓ -42% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $49.84 | ↓ -42% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $49.84 | ↓ -42% |
| Aetna | Better Health | $56.22 | ↓ -35% |
| United Healthcare | Community Plan | $57.69 | ↓ -33% |
| Fidelis Care | NJ Family Care | $58.79 | ↓ -32% |
| Aetna | HMO | $83.11 | ↓ -3% |
| Aetna | PPO | $83.11 | ↓ -3% |
| Cigna | HMO | $173.42 | ↑ +102% |
| Cigna | PPO | $173.42 | ↑ +102% |
| Cigna | Local Plus | $173.42 | ↑ +102% |
| Wellpoint | NJ Family Care | $235.98 | ↑ +175% |
| First Health | Commercial | $248.40 | ↑ +189% |
| Qualcare Inc | HMO/POS | $276.13 | ↑ +222% |
| Qualcare Inc | PPO/WC | $294.35 | ↑ +243% |
| Amerihealth | Regional Preferred | $308.43 | ↑ +259% |
| Amerihealth | Local Value | $308.43 | ↑ +259% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $351.90 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $378.76 | ↑ +341% |
Visitor-reported prices
Comments
M/phmtrc alys ishquant/semiq at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Cooperman Barnabas Medical Center | Livingston | $199.82 | $20.86 – $173.42 |
| Trinitas Regional Medical Center | Elizabeth | not published | $20.86 – $442.92 |
| Clara Maass Medical Center | Belleville | not published | $20.86 – $173.42 |
| Newark Beth Israel Medical Center | Newark | not published | $20.86 – $173.42 |
| Jersey City Medical Center | Jersey City | not published | $20.86 – $173.42 |
| Monmouth Medical Center | Long Branch | not published | $20.86 – $173.42 |
| Bayshore Medical Center | Holmdel | not published | $72.99 – $96.69 |
| Hackensack University Medical Center | Hackensack | not published | $39.50 – $605.49 |