Surgical pathology level 6 gross & microscopic examination at Community Medical Center
99 NJ-37, Toms River, NJ · RWJBarnabas Health · · NPI 1013010917
$322.50
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.
$1,555.00
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.
$145.96 with Horizon Blue Cross Blue Shield of New Jersey vs $1,776.61 with Wellcare — 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 | $145.96 | ↓ -55% |
| Aetna | Better Health | $211.16 | ↓ -35% |
| Amerihealth | Regional Preferred | $272.61 | ↓ -15% |
| Amerihealth | Local Value | $272.61 | ↓ -15% |
| Horizon Blue Cross Blue Shield of New Jersey | Omnia | $337.53 | ↑ +5% |
| Horizon Blue Cross Blue Shield of New Jersey | Non-Managed | $337.53 | ↑ +5% |
| Horizon Blue Cross Blue Shield of New Jersey | State Benefit Plan | $337.53 | ↑ +5% |
| Horizon Blue Cross Blue Shield of New Jersey | Managed | $337.53 | ↑ +5% |
| United Healthcare | Commercial | $345.51 | ↑ +7% |
| United Healthcare | Oxford Commercial | $345.51 | ↑ +7% |
| United Healthcare | Nexus | $364.96 | ↑ +13% |
| United Healthcare | Oxford Metro | $364.96 | ↑ +13% |
| United Healthcare | Community Plan | $370.36 | ↑ +15% |
| Fidelis Care | NJ Family Care | $377.41 | ↑ +17% |
| Aetna | HMO | $544.00 | ↑ +69% |
| Aetna | PPO | $544.00 | ↑ +69% |
| Wellpoint | NJ Family Care | $886.35 | ↑ +175% |
| Aetna | Medicare | $892.77 | ↑ +177% |
| Humana | Medicare | $892.77 | ↑ +177% |
| Wellpoint | Medicare Advantage | $892.77 | ↑ +177% |
| Clover Health | Medicare Advantage | $892.77 | ↑ +177% |
| Fidelis Care | Medicare Advantage | $892.77 | ↑ +177% |
| Horizon Blue Cross Blue Shield of New Jersey | Medicare Advantage | $892.77 | ↑ +177% |
| United Healthcare | Medicare | $910.63 | ↑ +182% |
| First Health | Commercial | $933.00 | ↑ +189% |
| Qualcare Inc | HMO/POS | $1,037.18 | ↑ +222% |
| Qualcare Inc | PPO/WC | $1,105.60 | ↑ +243% |
| Cigna | Local Plus | $1,174.36 | ↑ +264% |
| Cigna | PPO | $1,174.36 | ↑ +264% |
| Cigna | HMO | $1,174.36 | ↑ +264% |
| Horizon Blue Cross Blue Shield of New Jersey | Worker's Comp | $1,321.75 | ↑ +310% |
| Horizon Blue Cross Blue Shield of New Jersey | PIP | $1,422.66 | ↑ +341% |
| Emblem Health | Commercial | $1,562.35 | ↑ +384% |
| Wellcare | Ambetter Health Commercial | $1,776.61 | ↑ +451% |
Visitor-reported prices
Comments
Surgical pathology level 6 gross & microscopic examination at other New-jersey hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinitas Regional Medical Center | Elizabeth | $291.87 | $231.40 – $1,785.54 |
| Cooperman Barnabas Medical Center | Livingston | $278.86 | $145.96 – $1,833.00 |
| Clara Maass Medical Center | Belleville | $210.63 | $145.96 – $1,823.84 |
| Newark Beth Israel Medical Center | Newark | $274.12 | $145.96 – $1,833.00 |
| Jersey City Medical Center | Jersey City | $323.12 | $145.96 – $1,914.44 |
| Monmouth Medical Center | Long Branch | $340.23 | $145.96 – $1,799.34 |
| Bayshore Medical Center | Holmdel | $904.19 | $249.24 – $1,346.75 |
| Hackensack University Medical Center | Hackensack | $962.03 | $132.32 – $1,515.40 |