Prospect Medical Holdings · East Orange, NJ
18
In-network payers
273
Disclosed rate categories
201
Beds
1
Care quality
Pmh - East Orange General Hospital is a 201-bed voluntary non-profit - private hospital in East Orange, NJ, affiliated with Prospect Medical Holdings. Below you'll find publicly disclosed negotiated rates and facility details, including 18 in-network payers and 273 disclosed rate categories.
CCN (Medicare provider number)
310083
NPI
1013386143
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Private
Beds
201
Care Quality
1
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Pmh - East Orange General Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Medicine & Surgery · Inpatient
MS-DRG 216
$91,334 - $140,704
from 2 insurers · median $116,019
Hospital reports cardiac thoracic surgery services to CMS
Medicine & Surgery · Inpatient
MS-DRG 473
$23,754 - $37,890
from 2 insurers · median $30,822
Hospital reports neurosurgical services to CMS
Medicine & Surgery · Inpatient
MS-DRG 470
$19,037 - $30,141
from 2 insurers · median $24,589
Hospital reports orthopedic surgery services to CMS
Medicine & Surgery · Inpatient
MS-DRG 460
$55,450
negotiated rate
Hospital reports neurosurgical services to CMS
Medicine & Surgery · Inpatient
MS-DRG 743
$12,702 - $18,423
from 2 insurers · median $15,563
Hospital reports inpatient surgical services to CMS
Digestive procedures
CPT 43239
$433 - $2,347
from 3 insurers · median $1,954
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$589 - $2,952
from 3 insurers · median $1,951
Common here, based on CMS Medicare volume
CT imaging
CPT 74177
$368 - $652
from 3 insurers · median $459
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$662 - $3,025
from 3 insurers · median $1,951
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$207 - $921
from 3 insurers · median $890
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$2,975 - $27,511
from 3 insurers · median $16,071
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$491 - $2,348
from 3 insurers · median $1,951
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$109 - $230
from 3 insurers · median $184
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$230 - $413
from 3 insurers · median $336
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93970
$413 - $798
from 3 insurers · median $611
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$369 - $2,347
from 3 insurers · median $1,306
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$23 - $93
from 3 insurers · median $81
Common here, based on CMS Medicare volume
Gynecology
CPT 58558
$2,344 - $7,961
from 2 insurers · median $5,152
Typical for a hospital with this service line
CT imaging
CPT 71275
$179 - $490
from 3 insurers · median $361
Common here, based on CMS Medicare volume
Gynecology
CPT 58662
$2,975 - $15,127
from 3 insurers · median $9,218
Typical for a hospital with this service line
Mammography
CPT 77067
$63 - $180
from 3 insurers · median $97
Common here, based on CMS Medicare volume
Orthopedics and pain
CPT 29888
$2,978 - $18,103
from 3 insurers · median $12,478
Typical for a hospital with this service line
Orthopedics and pain
CPT 63030
$2,975 - $18,319
from 3 insurers · median $11,698
Typical for a hospital with this service line
MRI imaging
CPT 70551
$230 - $524
from 3 insurers · median $468
Common here, based on CMS Medicare volume
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 19 | 242% | 0 | 19 |
| Insurer B* | 23 | 164% | 3 | 18 |
| Insurer C* | 23 | 99% | 4 | 19 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 14 are common here based on CMS Medicare volume, and 10 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Pmh - East Orange General Hospital.
300 Central Avenue, East Orange, NJ 07018
(973) 266-4401
The nearest hospitals of similar type and size. Their rates are compared with Pmh - East Orange General Hospital for the same insurers and services above.
St. Michaels Medical Center
▲ Rates typically 29% higher than Pmh - East Orange General Hospital (24 services)
Hackensack Meridian Health Mountainside Medical Center
▲ Rates typically 116% higher than Pmh - East Orange General Hospital (24 services)
Hudson Regional Hospital
▲ Rates typically 33% higher than Pmh - East Orange General Hospital (24 services)
Bayonne Medical Center
▲ Rates typically 79% higher than Pmh - East Orange General Hospital (24 services)
St. Marys Hospital - Passaic
▲ Rates typically 21% higher than Pmh - East Orange General Hospital (24 services)
Christ Hospital
▲ Rates typically 84% higher than Pmh - East Orange General Hospital (24 services)
Monmouth Medical Center
Jersey Shore University Medical Center
Robert Wood Johnson University Hospital
About Pmh - East Orange General Hospital's rates and hospital price transparency.
For MRI of the brain, without contrast (CPT 70551), published negotiated rates at Pmh - East Orange General Hospital range from $230 to $524 across 3 insurers. Aetna's rate is $468. The median at nearby comparable hospitals is $536. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Pmh - East Orange General Hospital range from $368 to $652 across 3 insurers. UnitedHealthcare's rate is $368. The median at nearby comparable hospitals is $804. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with biopsy (CPT 45380), published negotiated rates at Pmh - East Orange General Hospital range from $589 to $2,952 across 3 insurers. Blue Cross Blue Shield's rate is $2,952. The median at nearby comparable hospitals is $3,944. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Pmh - East Orange General Hospital range from $63 to $180 across 3 insurers. UnitedHealthcare's rate is $97. The median at nearby comparable hospitals is $239. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Pmh - East Orange General Hospital range from $19,037 to $30,141 across 2 insurers. Aetna's rate is $30,141. The median at nearby comparable hospitals is $25,778. What a patient pays depends on their plan's deductible, coinsurance and network status.
Pmh - East Orange General Hospital has 201 beds. Facility type: Short Term Acute Care Hospital.
Pmh - East Orange General Hospital is located at 300 Central Avenue, East Orange, NJ 07018. Its main phone number is (973) 266-4401.
Pmh - East Orange General Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 310083.
The National Provider Identifier (NPI) on file for Pmh - East Orange General Hospital is 1013386143.
Pmh - East Orange General Hospital is affiliated with Prospect Medical Holdings.
Pmh - East Orange General Hospital lists 18 in-network payers, including Aetna, Aspirus Health Plan, Avera Health Plans, BCBS, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
273 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers