Opps service,sched team conf at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$242.24
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.
$1,168.00
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.
$144.94 with United Healthcare vs $1,068.60 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 | $144.94 | ↓ -40% |
| Fidelis Care | NJ Family Care | $147.63 | ↓ -39% |
| Aetna | Better Health | $158.61 | ↓ -35% |
| United Healthcare | Nexus | $336.38 | ↑ +39% |
| United Healthcare | Oxford Metro | $336.38 | ↑ +39% |
| United Healthcare | Commercial | $394.78 | ↑ +63% |
| United Healthcare | Oxford Commercial | $394.78 | ↑ +63% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $465.37 | ↑ +92% |
| Humana | Medicare | $465.37 | ↑ +92% |
| Aetna | Medicare | $465.37 | ↑ +92% |
| Wellpoint | Medicare Advantage | $465.37 | ↑ +92% |
| Clover Health | Medicare Advantage | $465.37 | ↑ +92% |
| Fidelis Care | Medicare Advantage | $465.37 | ↑ +92% |
| United Healthcare | Medicare | $474.68 | ↑ +96% |
| Aetna | HMO | $642.40 | ↑ +165% |
| Aetna | PPO | $642.40 | ↑ +165% |
| Wellpoint | NJ Family Care | $665.76 | ↑ +175% |
| Cigna | Local Plus | $693.79 | ↑ +186% |
| First Health | Commercial | $700.80 | ↑ +189% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $758.61 | ↑ +213% |
| Qualcare Inc | HMO/POS | $779.05 | ↑ +222% |
| Emblem Health | Commercial | $814.40 | ↑ +236% |
| Qualcare Inc | PPO/WC | $830.44 | ↑ +243% |
| Amerihealth | Regional Preferred | $870.16 | ↑ +259% |
| Amerihealth | Local Value | $870.16 | ↑ +259% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $876.00 | ↑ +262% |
| Cigna | HMO | $881.60 | ↑ +264% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $919.68 | ↑ +280% |
| Wellcare | Ambetter Health Commercial | $926.09 | ↑ +282% |
| Cigna | PPO | $928.56 | ↑ +283% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $934.75 | ↑ +286% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $992.80 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $1,068.60 | ↑ +341% |
Visitor-reported prices
Comments
Opps service,sched team conf at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $219.23 | $465.37 – $930.74 |
| Monmouth Medical Center | Long Branch | $255.55 | $471.32 – $937.93 |
| JFK Johnson Rehabilitation Institute (JRI) | Edison | $471.73 | $425.82 – $745.97 |
| Jersey Shore University Medical Center | Neptune City | $471.32 | $471.32 – $565.59 |
| Palisades Medical Center | North Bergen | $501.47 | $501.47 – $546.60 |
| Raritan Bay Medical Center | Perth Amboy | $471.73 | $471.73 – $566.08 |
| Riverview Medical Center | Red Bank | $471.32 | $471.32 – $565.59 |
| Southern Ocean Medical Center | Manahawkin | $465.37 | $465.37 – $558.44 |