Raritan Bay Medical Center
530 New Brunswick Avenue, Perth Amboy, NJ · Hackensack Meridian Health · · NPI 1790297455
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Diagnostic Mammogram (one breast) CPT 77065 | $164.52 | $737.00 | $123.32 – $323.35 | 10 |
| Diagnostic radio unlisted proc CPT 76499 | $97.54 | $246.00 | $68.21 – $219.04 | 8 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | $5,578.00 | $407.36 – $407.36 | 1 |
| Dialysis one evaluation CPT 90945 | $471.73 | $1,433.00 | $144.87 – $1,553.00 | 10 |
| Diathermy eg microwave CPT 97024 | $9.28 | not published | $9.28 – $12.96 | 7 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | $0.56 | $0.11 – $0.45 | 4 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | not published | $79.31 | $5.24 – $14.37 | 4 |
| Dicyclomine injection HCPCS J0500 | not published | $422.84 | $9.93 – $56.01 | 4 |
| Difelikefalin, esrd on dialy HCPCS J0879 | $0.08 | not published | $0.08 – $17.75 | 8 |
| Diffusing capacity CPT 94729 | not published | $875.00 | $78.08 – $464.00 | 4 |
| Digital analysis of eeg CPT 95957 | not published | $660.00 | $522.73 – $1,308.03 | 2 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | $54.53 | $3.40 – $34.38 | 4 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $4,968.58 | $24,060.24 | $4,223.29 – $8,865.29 | 9 |
| Digoxin total therapeutic drug level CPT 80162 | $13.28 | $165.00 | $13.28 – $60.85 | 11 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | $802.61 | $56.31 – $122.43 | 4 |
| Dilate biliary duct/ampulla CPT 47542 | not published | $3,007.00 | $274.44 – $274.44 | 1 |
| Dilate esophagus CPT 43453 | $2,101.52 | $3,549.00 | $183.44 – $2,521.83 | 8 |
| Dilate esophagus 1/mult pass CPT 43450 | $1,038.65 | $3,285.00 | $168.75 – $1,246.38 | 8 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | $3,860.00 | $672.67 – $672.67 | 1 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | $559.00 | $336.34 – $336.34 | 1 |
| Dilate ic vasospasm init CPT 61640 | not published | $1,257.00 | $957.72 – $957.72 | 1 |
| Dilate tear duct opening CPT 68801 | $442.06 | $802.00 | $173.70 – $530.48 | 8 |
| Dilate urethra stricture CPT 53600 | $269.43 | $994.00 | $132.30 – $323.32 | 8 |
| Dilate urethra stricture CPT 53601 | $142.80 | $300.00 | $111.50 – $171.36 | 8 |
| Dilate urethra stricture CPT 53605 | $3,820.84 | $5,441.00 | $132.47 – $4,585.01 | 8 |
| Dilate urethra stricture CPT 53621 | $269.43 | not published | $56.00 – $323.32 | 9 |
| Dilation/female urethra/initial 53660 CPT 53660 | $173.33 | not published | $40.00 – $208.00 | 9 |
| Dilation of anal sphincter CPT 45905 | $1,306.21 | $5,429.00 | $368.29 – $1,567.45 | 8 |
| Dilation of cervical canal 57800 CPT 57800 | $3,522.35 | $5,540.00 | $103.04 – $4,226.82 | 8 |
| Dilation of rectal stricture 45910 CPT 45910 | $1,306.21 | $5,385.00 | $415.65 – $1,567.45 | 8 |
| Dilation of salivary duct CPT 42660 | $564.16 | $1,029.00 | $186.18 – $676.99 | 8 |
| Dilation of urethra CPT 53661 | $142.80 | not published | $40.00 – $171.36 | 9 |
| Dilation of urethra CPT 53665 | $2,269.38 | $4,012.00 | $78.54 – $2,723.26 | 8 |
| Dilation of vagina CPT 57400 | $3,522.35 | $6,167.00 | $276.16 – $4,226.82 | 8 |
| Dilation salivary duct 42650 CPT 42650 | $1,640.99 | $4,005.00 | $128.16 – $1,969.19 | 8 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $739.44 | $3,837.00 | $181.89 – $887.32 | 8 |
| Dilator fascial 10fx20cm HCPCS C2627 | not published | $784.37 | not published | 0 |
| Dilat xst trc ndurlgc px CPT 50436 | $3,820.84 | $6,146.00 | $309.03 – $4,585.01 | 8 |
| Dilat xst trc new access rcs CPT 50437 | $3,820.84 | $9,427.00 | $509.88 – $4,585.01 | 8 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | not published | not published | $0.03 – $0.03 | 1 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $76.75 – $76.75 | 1 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $6.58 – $15.59 | 4 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $742.90 | $3,725.20 | $631.47 – $1,367.01 | 9 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.13 – $0.64 | 2 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | not published | $20.37 | $0.77 – $1.72 | 4 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | $218.50 | $11.98 – $11.98 | 1 |
| Dir nsl mucous membrane test CPT 95065 | $43.48 | not published | $6.05 – $52.79 | 9 |
| Disability dlco CPT 94727 | $173.33 | $1,265.00 | $60.88 – $464.00 | 10 |
| Disaccharidases CPT 82657 | $22.17 | $2,805.00 | $22.17 – $101.59 | 11 |
| Disarticulation sho sec clsr CPT 23921 | $2,026.46 | not published | $1,042.87 – $2,431.75 | 8 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | $4,026.00 | $3,116.54 – $3,116.54 | 1 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $265.00 – $434.19 | 2 |
| Discography cerv/thor spine CPT 72285 | $2,163.32 | $5,057.00 | $112.50 – $4,750.01 | 11 |
| Dise eval slp do brth flx dx CPT 42975 | $1,910.40 | $2,226.00 | $206.84 – $2,292.48 | 8 |
| Dissolve clot heart vessel CPT 92975 | not published | $1,085.00 | $455.00 – $616.32 | 2 |
| Dist revas ligation hemo CPT 36838 | $5,988.54 | $9,334.00 | $2,324.33 – $7,186.25 | 8 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | $6,553.49 | $12,472.00 | $1,699.19 – $7,864.18 | 8 |
| Division of fallopian tube 58605 CPT 58605 | not published | $869.00 | $726.70 – $726.70 | 1 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $33.31 – $55.76 | 2 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | $1,349.00 | $593.36 – $593.36 | 1 |
| Dmd dup/delet analysis CPT 81161 | $279.00 | $1,340.00 | $220.16 – $1,278.48 | 11 |
| Dmpk gene detc abnor allele CPT 81234 | $137.00 | $755.00 | $137.00 – $627.78 | 11 |
| Dna antibody native/double stranded CPT 86225 | $13.74 | $276.00 | $13.74 – $62.96 | 11 |
| Dna gardnerella CPT 87510 | $20.05 | $106.00 | $20.05 – $91.88 | 11 |
| Dna probe chlamydia CPT 87490 | $22.75 | not published | $22.75 – $104.25 | 12 |
| Dna probe gc CPT 87590 | $26.88 | not published | $26.88 – $123.17 | 12 |
| Dna trichomonas CPT 87660 | $20.05 | $106.00 | $20.05 – $91.88 | 11 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | not published | $111.22 | $6.78 – $13.10 | 4 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | not published | $18.53 | $0.32 – $1.32 | 4 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | $49.08 | not published | $41.72 – $58.90 | 8 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $11.09 – $11.09 | 1 |
| Dolasetron mesylate oral HCPCS Q0180 | not published | not published | $127.62 – $127.62 | 1 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | not published | $6.97 | $0.56 – $1.42 | 4 |
| Doppler echo complete CPT 93320 | not published | $1,274.00 | $90.08 – $2,961.00 | 4 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | not published | $3,655.00 | $395.88 – $602.64 | 2 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $173.33 | $1,518.00 | $173.33 – $1,190.00 | 10 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $142.80 | $704.00 | $142.80 – $1,190.00 | 10 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $1.30 – $1.30 | 1 |
| Dornase alfa non-comp unit HCPCS J7639 | not published | not published | $46.89 – $102.67 | 4 |
| Dornhoffer fixed part w/window HCPCS L8614 | not published | $83,600.80 | $18,198.48 – $36,123.85 | 2 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $243.82 | not published | $207.25 – $461.97 | 10 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | not published | not published | $2.31 – $6.46 | 4 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $109.28 | $2,391.57 | $92.89 – $430.62 | 9 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | not published | not published | $0.10 – $0.10 | 1 |
| Dpyd gene common variants CPT 81232 | $174.81 | $616.00 | $174.81 – $801.04 | 11 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $779.45 | $1,021.00 | $54.45 – $935.34 | 10 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $779.45 | $1,240.00 | $63.00 – $935.34 | 10 |
| Drainage external ear complex 69005 CPT 69005 | $1,794.93 | $6,247.00 | $152.50 – $2,153.92 | 10 |
| Drainage external ear simple 69000 CPT 69000 | $779.45 | $1,533.00 | $77.15 – $935.34 | 11 |
| Drainage lymph node lesion 38300 CPT 38300 | $3,170.64 | $6,377.00 | $458.79 – $3,804.76 | 8 |
| Drainage lymph node lesion 38305 CPT 38305 | $3,170.64 | not published | $1,071.54 – $3,804.76 | 8 |
| Drainage mouth roof lesion CPT 42000 | $257.26 | $721.00 | $54.45 – $795.00 | 10 |
| Drainage of arm bursa 23931 CPT 23931 | $1,794.93 | $4,808.00 | $59.00 – $2,153.92 | 10 |
| Drainage of bladder abscess CPT 51080 | $3,170.64 | not published | $876.26 – $3,804.76 | 8 |
| Drainage of eye CPT 65800 | $2,526.64 | $4,830.00 | $187.02 – $3,031.97 | 8 |
| Drainage of eye CPT 65810 | $2,526.64 | $5,372.00 | $999.82 – $3,031.97 | 8 |
| Drainage of eye CPT 65815 | $2,526.64 | $5,346.00 | $1,025.68 – $3,031.97 | 8 |
| Drainage of forearm bursa CPT 25031 | $1,772.97 | $4,748.00 | $72.60 – $2,127.56 | 10 |
| Drainage of kidney lesion CPT 50390 | $779.45 | $2,506.00 | $193.13 – $935.34 | 8 |
| Drainage of mouth lesion CPT 41005 | $257.26 | $1,219.00 | $127.05 – $795.00 | 10 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.