Surgical pathology level 5 gross & microscopic examination at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$317.32
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.
$1,530.00
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.
$96.76 with Horizon Blue Cross Blue Shield of New Jersey vs $1,399.79 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 |
|---|---|---|---|
| Horizon Blue Cross Blue Shield of New Jersey | NJ Health | $96.76 | ↓ -70% |
| United Healthcare | Nexus | $152.33 | ↓ -52% |
| United Healthcare | Oxford Metro | $152.33 | ↓ -52% |
| United Healthcare | Oxford Commercial | $155.88 | ↓ -51% |
| United Healthcare | Commercial | $155.88 | ↓ -51% |
| Amerihealth | Local Value | $201.07 | ↓ -37% |
| Amerihealth | Regional Preferred | $201.07 | ↓ -37% |
| Aetna | Better Health | $207.77 | ↓ -35% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $240.44 | ↓ -24% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $240.44 | ↓ -24% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $240.44 | ↓ -24% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $240.44 | ↓ -24% |
| United Healthcare | Community Plan | $246.97 | ↓ -22% |
| Fidelis Care | NJ Family Care | $251.67 | ↓ -21% |
| Aetna | HMO | $365.00 | ↑ +15% |
| Aetna | PPO | $365.00 | ↑ +15% |
| Aetna | Medicare | $393.13 | ↑ +24% |
| Clover Health | Medicare Advantage | $393.13 | ↑ +24% |
| Fidelis Care | Medicare Advantage | $393.13 | ↑ +24% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $393.13 | ↑ +24% |
| Wellpoint | Medicare Advantage | $393.13 | ↑ +24% |
| Humana | Medicare | $393.13 | ↑ +24% |
| United Healthcare | Medicare | $400.99 | ↑ +26% |
| Emblem Health | Commercial | $687.98 | ↑ +117% |
| Wellcare | Ambetter Health Commercial | $782.33 | ↑ +147% |
| Cigna | Local Plus | $836.55 | ↑ +164% |
| Cigna | PPO | $836.55 | ↑ +164% |
| Cigna | HMO | $836.55 | ↑ +164% |
| Wellpoint | NJ Family Care | $872.10 | ↑ +175% |
| First Health | Commercial | $918.00 | ↑ +189% |
| Qualcare Inc | HMO/POS | $1,020.51 | ↑ +222% |
| Qualcare Inc | PPO/WC | $1,087.83 | ↑ +243% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $1,300.50 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $1,399.79 | ↑ +341% |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $287.18 | $152.33 – $836.55 |
| Cooperman Barnabas Medical Center | Livingston | $274.41 | $96.76 – $836.55 |
| Clara Maass Medical Center | Belleville | $221.77 | $96.76 – $836.55 |
| Newark Beth Israel Medical Center | Newark | $269.74 | $96.76 – $836.55 |
| Jersey City Medical Center | Jersey City | $317.93 | $96.76 – $843.02 |
| Monmouth Medical Center | Long Branch | $334.76 | $96.76 – $836.55 |
| Bayshore Medical Center | Holmdel | $398.16 | $180.98 – $597.81 |
| Hackensack University Medical Center | Hackensack | $423.63 | $87.72 – $672.67 |