Noninv pace analysis at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$213.62
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.
$1,030.00
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.
$127.82 with United Healthcare vs $1,113.00 with United Healthcare — 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 | $127.82 | ↓ -40% |
| Fidelis Care | NJ Family Care | $130.19 | ↓ -39% |
| Aetna | Better Health | $139.87 | ↓ -35% |
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $286.47 | ↑ +34% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $327.77 | ↑ +53% |
| Humana | Medicare | $327.77 | ↑ +53% |
| Fidelis Care | Medicare Advantage | $327.77 | ↑ +53% |
| Wellpoint | Medicare Advantage | $327.77 | ↑ +53% |
| Clover Health | Medicare Advantage | $327.77 | ↑ +53% |
| Aetna | Medicare | $327.77 | ↑ +53% |
| United Healthcare | Medicare | $334.33 | ↑ +57% |
| Aetna | HMO | $566.50 | ↑ +165% |
| Aetna | PPO | $566.50 | ↑ +165% |
| Emblem Health | Commercial | $573.60 | ↑ +169% |
| Wellpoint | NJ Family Care | $587.10 | ↑ +175% |
| Cigna | Local Plus | $611.82 | ↑ +186% |
| First Health | Commercial | $618.00 | ↑ +189% |
| Wellcare | Ambetter Health Commercial | $652.26 | ↑ +205% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $668.98 | ↑ +213% |
| Qualcare Inc | HMO/POS | $687.01 | ↑ +222% |
| Qualcare Inc | PPO/WC | $732.33 | ↑ +243% |
| Amerihealth | Regional Preferred | $767.35 | ↑ +259% |
| Amerihealth | Local Value | $767.35 | ↑ +259% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $772.50 | ↑ +262% |
| Cigna | HMO | $777.44 | ↑ +264% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $811.02 | ↑ +280% |
| Cigna | PPO | $818.85 | ↑ +283% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $824.30 | ↑ +286% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $875.50 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $942.34 | ↑ +341% |
| United Healthcare | Nexus | $946.00 | ↑ +343% |
| United Healthcare | Oxford Metro | $946.00 | ↑ +343% |
| United Healthcare | Commercial | $1,113.00 | ↑ +421% |
| United Healthcare | Oxford Commercial | $1,113.00 | ↑ +421% |
Visitor-reported prices
Comments
Noninv pace analysis at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Cooperman Barnabas Medical Center | Livingston | $135.82 | $279.73 – $672.96 |
| Clara Maass Medical Center | Belleville | $98.05 | $276.36 – $669.60 |
| Newark Beth Israel Medical Center | Newark | $133.52 | $144.36 – $672.96 |
| Monmouth Medical Center | Long Branch | $225.36 | $331.96 – $660.60 |
| Bayshore Medical Center | Holmdel | $331.96 | $298.47 – $361.83 |
| Hackensack University Medical Center | Hackensack | $353.19 | $282.55 – $474.60 |
| Ocean University Medical Center | Brick | $327.77 | $298.47 – $580.45 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $332.25 | $299.91 – $580.45 |