Raritan Bay Medical Center

530 New Brunswick Ave, Perth Amboy, NJ 08861 · Acute care hospital · Emergency room

These are Raritan Bay Medical Center's own posted figures from its standard-charges file dated December 31, 2025. They are not a quote. Source: the hospital's file · its price transparency page.

233 of the services we track have a posted price here; 199 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.

Emergency room

Service	Cash price	Gross charge	Insurer rates (min – max)
Critical care, first 30 to 74 minutes CPT 99291	$933.46	$5,390.00	$355.15 – $1,522.00
Emergency room visit, level 1 (minor) CPT 99281	$97.54	$649.00	$19.04 – $1,522.00
Emergency room visit, level 2 CPT 99282	$175.43	$1,348.00	$69.41 – $1,522.00
Emergency room visit, level 3 (moderate) CPT 99283	$306.74	$2,090.00	$118.01 – $1,938.00
Emergency room visit, level 4 CPT 99284	$471.73	$3,025.00	$140.00 – $1,938.00
Emergency room visit, level 5 (most severe) CPT 99285	$679.20	$4,125.00	$140.00 – $1,938.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$220.12	$825.00	$93.97 – $795.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	not posted	$440.00	$68.20 – $428.08
New patient office visit, about 30 minutes CPT 99203	not posted	$1,870.00	$289.85 – $1,819.32
New patient office visit, about 45 minutes CPT 99204	not posted	$2,057.00	$273.58 – $2,001.26
New patient office visit, about 60 minutes CPT 99205	not posted	$770.00	$119.35 – $749.13
Office consultation, about 40 minutes CPT 99243	not posted	$550.00	$73.15 – $535.10
Office consultation, about 60 minutes CPT 99244	not posted	$825.00	$109.73 – $802.64
Office visit, established patient, about 10 to 19 minutes CPT 99212	not posted	$314.00	$48.67 – $305.49
Office visit, established patient, about 20 to 29 minutes CPT 99213	not posted	$374.00	$57.97 – $363.86
Office visit, established patient, about 30 to 39 minutes CPT 99214	not posted	$495.00	$76.73 – $481.59
Office visit, established patient, about 40 to 54 minutes CPT 99215	not posted	$605.00	$93.78 – $588.60
Office visit, established patient, brief (often a nurse) CPT 99211	not posted	$275.00	$42.63 – $267.55
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted	$173.00	$23.01 – $168.31
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted	$132.00	$17.56 – $128.42

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$65.52	$222.00	$29.53 – $214.45
Abdominal X-ray, 1 view CPT 74018	$97.54	$473.00	$62.91 – $456.92
Ankle X-ray, 3 or more views CPT 73610	$97.54	$633.00	$84.19 – $611.48
Bone density scan (DEXA), hips and spine CPT 77080	$117.81	$935.00	$124.36 – $903.21
Breast ultrasound, one breast, complete CPT 76641	$117.81		$108.36 – $295.04
Breast ultrasound, one breast, limited CPT 76642	$97.54		$102.19 – $219.04
Chest X-ray, 1 view CPT 71045	$97.54	$429.00	$57.06 – $414.41
Chest X-ray, 2 views CPT 71046	$97.54	$497.00	$66.10 – $480.10
CT angiogram of the chest (checks for lung clots) CPT 71275	$197.21	$3,587.00	$393.59 – $2,921.00
CT angiogram of the head CPT 70496	$197.21	$3,443.00	$416.25 – $2,921.00
CT scan of the abdomen and pelvis, with contrast CPT 74177	$395.64	$4,650.00	$601.94 – $2,921.00
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$395.64	$6,430.00	$675.55 – $2,921.00
CT scan of the abdomen and pelvis, without contrast CPT 74176	$267.78	$3,740.00	$315.17 – $2,921.00
CT scan of the abdomen, without contrast CPT 74150	$117.81	$1,980.00	$251.91 – $2,921.00
CT scan of the chest, with contrast CPT 71260	$197.21	$3,354.00	$330.15 – $2,921.00
CT scan of the chest, without contrast CPT 71250	$117.81	$2,692.00	$254.78 – $2,921.00
CT scan of the head, without contrast CPT 70450	$117.81	$2,504.00	$203.98 – $2,921.00
CT scan of the neck (cervical spine), without contrast CPT 72125	$117.81	$2,970.00	$256.35 – $2,921.00
CT scan of the pelvis, with contrast CPT 72193	$197.21	$3,245.00	$369.20 – $2,921.00
CT scan of the sinuses or face, without contrast CPT 70486	$117.81	$2,420.00	$253.40 – $2,921.00
Diagnostic mammogram, both breasts CPT 77066	$207.95	$1,045.00	$138.99 – $1,009.47
Diagnostic mammogram, one breast CPT 77065	$164.52	$737.00	$98.02 – $711.94
Foot X-ray, 3 or more views CPT 73630	$97.54	$649.00	$86.32 – $626.93
Hand X-ray, 3 or more views CPT 73130	$97.54	$550.00	$73.15 – $531.30
Knee X-ray, 3 views CPT 73562	$97.54	$688.00	$91.50 – $664.61
Leg or arm vein ultrasound, both sides CPT 93970	$267.78	$2,682.00	$356.71 – $2,609.32
Leg or arm vein ultrasound, one side CPT 93971	$117.81	$1,708.00	$227.16 – $1,661.71
Lower back X-ray, 2 or 3 views CPT 72100	$117.81	$743.00	$98.82 – $717.74
MRI of both breasts, without and with contrast CPT 77049	not posted	$5,583.00	$679.55 – $4,332.00
MRI of the abdomen, without and with contrast CPT 74183	$395.64	$5,225.00	$671.04 – $4,332.00
MRI of the brain, without and with contrast CPT 70553	$395.64	$5,631.00	$630.32 – $4,332.00
MRI of the brain, without contrast CPT 70551	$267.78	$4,073.00	$387.86 – $4,332.00
MRI of the knee or other leg joint, without contrast CPT 73721	$267.78	$4,290.00	$401.87 – $4,332.00
MRI of the lower back (lumbar spine), without contrast CPT 72148	$267.78	$4,439.00	$378.00 – $4,332.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$267.78	$4,329.00	$376.03 – $4,332.00
MRI of the neck (cervical spine), without contrast CPT 72141	$267.78	$4,263.00	$376.69 – $4,332.00
MRI of the pelvis, without and with contrast CPT 72197	$395.64	$5,473.00	$668.41 – $4,332.00
MRI of the shoulder or other arm joint, without contrast CPT 73221	$267.78	$4,113.00	$402.52 – $4,332.00
Neck X-ray, 2 or 3 views CPT 72040	$97.54	$600.00	$79.80 – $579.60
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$117.81	$1,293.00	$171.97 – $1,249.04
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$117.81	$825.00	$109.73 – $796.95
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$117.81	$1,180.00	$156.94 – $1,139.88
Screening mammogram, both breasts CPT 77067	$169.06	$748.00	$99.48 – $722.57
Shoulder X-ray, 2 or more views CPT 73030	$97.54	$688.00	$91.50 – $664.61
Transvaginal pregnancy ultrasound CPT 76817	$117.81	$990.00	$131.67 – $956.34
Transvaginal ultrasound CPT 76830	$117.81	$1,255.00	$166.92 – $1,212.33
Ultrasound of the abdomen, complete CPT 76700	$117.81	$1,362.00	$181.15 – $1,315.69
Ultrasound of the neck or thyroid CPT 76536	$117.81	$1,210.00	$160.93 – $1,168.86
Wrist X-ray, 3 or more views CPT 73110	$97.54	$600.00	$79.80 – $579.60
X-ray of the lower back, 4 or more views CPT 72110	$117.81	$1,019.00	$135.53 – $984.35

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$8.46	$187.00	$24.87 – $181.93
Blood culture CPT 87040	$10.32	$229.00	$30.46 – $222.79
Blood draw (venipuncture) CPT 36415	$9.09	$75.00	$9.98 – $72.97
BNP test (heart failure) CPT 83880	$39.26	$288.00	$38.30 – $280.20
C-reactive protein (CRP) test CPT 86140	$5.18	$108.00	$14.36 – $105.07
Chlamydia test (DNA/NAAT) CPT 87491	$35.09	$298.00	$39.63 – $289.92
Complete blood count (CBC) with differential CPT 85025	$7.77	$165.00	$21.95 – $160.53
Complete blood count (CBC), automated CPT 85027	$6.47	$106.00	$14.10 – $103.13
Comprehensive metabolic panel (blood test) CPT 80053	$10.56	$650.00	$86.45 – $632.39
COVID-19 PCR test CPT 87635	$51.31	$314.00	$41.76 – $305.49
D-dimer test (blood clots) CPT 85379	$10.18	$127.00	$16.89 – $123.56
Drug screen, instrument chemistry CPT 80307	$62.14	$248.00	$32.98 – $241.28
Ferritin (iron stores) test CPT 82728	$13.63	$210.00	$27.93 – $204.31
Free T4 (thyroid) test CPT 84439	$9.02	$162.00	$21.55 – $157.61
General health panel (blood tests) CPT 80050	not posted	$1,232.00	$163.86 – $1,198.61
Glucose (blood sugar) test CPT 82947	$3.93	$48.00	$6.38 – $46.70
Gonorrhea test (DNA/NAAT) CPT 87591	$35.09	$286.00	$38.04 – $278.25
Hemoglobin A1c test CPT 83036	$9.71	$55.00	$7.32 – $53.51
Hepatitis C antibody test CPT 86803	$14.27	$226.00	$30.06 – $219.88
HIV-1/HIV-2 antigen and antibody test CPT 87389	$24.08	$245.00	$32.59 – $238.36
Iron test CPT 83540	$6.47	$105.00	$13.97 – $102.15
Kidney function panel CPT 80069	$8.68	$197.00	$26.20 – $191.66
Lipase test (pancreas) CPT 83690	$6.89	$132.00	$17.56 – $128.42
Lipid panel, cholesterol and triglycerides CPT 80061	$13.39	$260.00	$34.58 – $252.95
Liver function panel CPT 80076	$8.17	$167.00	$22.21 – $162.47
Magnesium test CPT 83735	$6.70	$138.00	$18.35 – $134.26
Obstetric blood test panel CPT 80055	$47.81	$326.00	$43.36 – $317.17
Partial thromboplastin time (PTT), clotting test CPT 85730	$6.01	$132.00	$17.56 – $128.42
Pregnancy blood test (hCG), quantitative CPT 84702	$15.05	$220.00	$29.26 – $214.04
Prothrombin time (PT/INR), clotting test CPT 85610	$4.29	$97.00	$12.90 – $94.37
PSA (prostate specific antigen), free CPT 84154	$18.39	$171.00	$22.74 – $166.37
PSA (prostate specific antigen), total CPT 84153	$18.39	$328.00	$43.62 – $319.11
Rapid strep test CPT 87880	$16.53	$83.00	$11.04 – $80.75
Sed rate (ESR) test CPT 85652	$2.70	$81.00	$10.77 – $78.80
TB skin test CPT 86580	$27.13	$66.71	$12.01 – $64.44
Thyroid stimulating hormone (TSH) CPT 84443	$16.80	$266.00	$35.38 – $258.79
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$59.19	$1,519.00	$202.03 – $1,477.84
Troponin test (heart damage) CPT 84484	$12.47	$173.00	$23.01 – $168.31
Urinalysis, automated, with microscope CPT 81001	$3.17	$107.00	$14.23 – $104.10
Urinalysis, automated, without microscope CPT 81003	$2.25	$80.00	$10.64 – $77.83
Urinalysis, manual, with microscope CPT 81000	$4.02		$4.02 – $4.82
Urinalysis, manual, without microscope CPT 81002	$3.48	$45.00	$5.99 – $43.78
Urine culture, colony count CPT 87086	$8.07	$154.00	$20.48 – $149.83
Urine pregnancy test CPT 81025	$8.61	$138.00	$18.35 – $134.26
Vitamin B12 test CPT 82607	$15.08	$160.00	$21.28 – $155.66
Vitamin D test CPT 82306	$29.60	$450.00	$59.85 – $437.81

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$267.78	$2,090.00	$277.97 – $2,033.36
ECG tracing only (no interpretation) CPT 93005	$65.80	$359.00	$47.75 – $349.27
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$607.42	$4,021.00	$534.79 – $3,912.03
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$25.03 – $220.00
Holter monitor, up to 48 hours CPT 93224	not posted		$128.84 – $612.50
Left heart catheterization CPT 93452	$3,563.20	$15,597.00	$2,379.00 – $19,497.00
Left heart catheterization with coronary angiogram CPT 93458	$3,563.20	$18,028.00	$2,379.00 – $19,497.00
Nuclear stress test (heart perfusion imaging) CPT 78452	$1,446.24	$6,381.00	$848.67 – $6,164.05
Treadmill stress test, complete CPT 93015	not posted	$201.00	$26.73 – $195.55

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$7,913.97	$13,167.00	$2,379.00 – $23,041.00
Appendix removal, laparoscopic CPT 44970	$6,463.42	$11,880.00	$2,379.00 – $23,041.00
Breast biopsy with ultrasound guidance CPT 19083	$1,794.93		$1,794.93 – $2,153.92
Carpal tunnel release CPT 64721	$2,163.32	$5,972.00	$1,189.00 – $10,156.00
Colonoscopy with biopsy CPT 45380	$1,306.21	$4,294.00	$1,189.00 – $9,933.00
Colonoscopy with polyp removal (snare) CPT 45385	$1,306.21	$4,235.00	$1,189.00 – $9,933.00
Colonoscopy, diagnostic CPT 45378	$1,010.01	$4,235.00	$1,010.01 – $9,933.00
Colposcopy with biopsy CPT 57454	$336.99	$703.00	$336.99 – $9,933.00
Cystoscopy (bladder scope) CPT 52000	$739.44	$5,170.00	$606.70 – $8,419.00
Ear tubes, under general anesthesia CPT 69436	$1,640.99		$1,640.99 – $1,969.19
Flexible sigmoidoscopy, diagnostic CPT 45330	$1,010.01	$2,610.00	$1,010.01 – $9,933.00
Gallbladder removal, laparoscopic CPT 47562	$6,463.42	$10,973.00	$2,379.00 – $23,041.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted	$5,266.00	$2,379.00 – $43,121.00
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$11,533.76	$15,125.00	$2,379.00 – $23,041.00
Hysteroscopy with biopsy or polyp removal CPT 58558	$3,522.35	$7,159.00	$1,189.00 – $10,156.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	$6,463.42		$6,463.42 – $7,756.10
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$3,909.56		$3,909.56 – $4,691.48
Kidney stone shock-wave lithotripsy CPT 50590	$3,820.84	$12,375.00	$2,379.00 – $23,041.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$3,594.44		$3,594.44 – $4,313.33
Lower colon endoscopy with ultrasound CPT 45391	$1,306.21	$4,490.00	$1,189.00 – $9,933.00
Nasal endoscopy, diagnostic CPT 31231	$215.07	$430.00	$215.07 – $9,933.00
Prostate biopsy CPT 55700	$2,269.38	$6,930.00	$1,189.00 – $9,933.00
Prostate removal, laparoscopic or robotic CPT 55866	$11,533.76	$14,441.00	$2,379.00 – $26,906.00
Removal of a breast lump, open surgery CPT 19120	$4,242.15		$4,242.15 – $5,090.58
Rotator cuff repair, arthroscopic CPT 29827	$7,913.97	$9,870.00	$2,379.00 – $23,041.00
Screening colonoscopy, average risk HCPCS G0121	$1,010.01	$4,023.00	$1,010.01 – $9,933.00
Screening colonoscopy, high risk HCPCS G0105	$1,010.01	$4,455.00	$1,010.01 – $9,933.00
Septoplasty (nasal septum repair) CPT 30520	$3,592.74	$5,580.00	$1,189.00 – $10,156.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$359.29 – $5,694.36
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted	$4,384.00	$2,379.00 – $43,121.00
Tonsil and adenoid removal, under age 12 CPT 42820	$6,553.49	$9,176.00	$1,189.00 – $10,156.00
Total hip replacement CPT 27130	$14,254.12		$14,254.12 – $17,104.94
Total knee replacement CPT 27447	$14,254.12		$14,254.12 – $17,104.94
Upper endoscopy (EGD) with biopsy CPT 43239	$1,038.65	$4,106.00	$1,038.65 – $9,933.00
Upper endoscopy (EGD), diagnostic CPT 43235	$1,038.65	$4,476.00	$1,038.65 – $9,933.00
Vasectomy CPT 55250	$2,269.38	$5,816.00	$606.70 – $10,156.00

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	not posted		$1,495.00 – $5,735.60
Fetal non-stress test CPT 59025	$222.86	$1,419.00	$188.73 – $1,380.55
IUD insertion CPT 58300	not posted	$464.00	$606.70 – $9,933.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$5,406.57 – $5,406.57
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted	$5,834.00	$795.00 – $5,167.05

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$7,630.84	$4,529.00 – $33,330.40
C-section, without complications MS-DRG 788	$7,825.46	$6,188.00 – $34,574.00
Chest pain MS-DRG 313	$6,170.75	$4,529.00 – $27,150.00
COPD flare-up, with major complications MS-DRG 190	$9,713.70	$4,529.00 – $45,706.00
COPD flare-up, without complications MS-DRG 192	$5,598.14	$4,529.00 – $27,795.00
Fainting (syncope) MS-DRG 312	$7,536.55	$4,529.00 – $32,918.59
Gastrointestinal bleeding, with complications MS-DRG 378	$8,527.82	$4,529.00 – $38,014.00
Heart failure, with major complications MS-DRG 291	$11,286.23	$4,529.00 – $51,645.00
Heart failure, without complications MS-DRG 293	$4,746.13	$4,475.00 – $25,550.00
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	$83,479.89	$5,095.00 – $376,985.00
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	$16,309.16	$5,095.00 – $76,380.00
Irregular heartbeat, without complications MS-DRG 310	$4,839.55	$3,819.00 – $21,584.00
Kidney failure, with complications MS-DRG 683	$7,688.79	$4,529.00 – $35,277.00
Kidney or urinary tract infection, without major complications MS-DRG 690	$6,942.31	$4,529.00 – $30,482.00
Neck (cervical) spinal fusion, without complications MS-DRG 473	$20,477.49	$5,095.00 – $91,086.00
Normal newborn care MS-DRG 795	$1,728.23	$1,279.00 – $8,890.00
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$6,758.94	$4,529.00 – $29,522.07
Pneumonia, with complications MS-DRG 194	$7,092.82	$4,529.00 – $34,555.00
Pneumonia, with major complications MS-DRG 193	$11,397.82	$4,529.00 – $50,543.00
Pneumonia, without complications MS-DRG 195	$5,386.22	$4,529.00 – $26,364.00
Psychoses (inpatient psychiatric stay) MS-DRG 885	$12,192.73	$4,529.00 – $53,256.10
Sepsis, with major complications MS-DRG 871	$16,971.73	$4,529.00 – $74,130.10
Sepsis, without major complications MS-DRG 872	$8,917.92	$4,529.00 – $40,417.00
Skin infection (cellulitis), without major complications MS-DRG 603	$7,618.73	$4,529.00 – $33,277.50
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$31,678.29 – $31,678.29
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$6,749.42	$4,529.00 – $29,480.51
Stroke, with complications or clot-busting drug MS-DRG 65	$8,795.96	$4,529.00 – $39,595.00
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	$10,368.49	$5,095.00 – $45,288.08
Vaginal delivery, without complications MS-DRG 807	$5,512.50	$4,280.00 – $23,582.00
Weight loss surgery, without complications MS-DRG 621	$12,644.25	$5,095.00 – $77,888.00

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$327.02		$327.02 – $392.42
Lower back nerve root injection with imaging guidance CPT 64483	$986.28		$986.28 – $1,183.54
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$767.19	$4,620.00	$767.19 – $9,933.00
Lower back spinal injection (epidural), without imaging CPT 62322	$986.28	$2,396.00	$986.28 – $9,933.00

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	$2,526.64	$7,351.00	$1,189.00 – $10,156.00
Eye exam, new patient, comprehensive CPT 92004	$142.76		$142.76 – $171.32
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$607.75	$2,869.00	$381.58 – $2,605.05

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$173.33	$567.00	$75.41 – $551.63

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$173.33	$1,925.00	$256.03 – $1,872.83
Sleep study with CPAP titration CPT 95811	$1,127.09	$9,782.00	$1,301.01 – $9,516.91
Sleep study, overnight in a sleep lab CPT 95810	$1,127.09	$9,011.00	$1,198.46 – $8,766.80

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$173.33	$1,375.00	$182.88 – $1,337.74

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$35.04	$202.00	$46.73 – $471.00
Physical therapy evaluation, low complexity CPT 97161	$126.19	$396.00	$90.00 – $517.00
Physical therapy evaluation, moderate complexity CPT 97162	$126.19	$453.00	$90.00 – $517.00
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$37.06	$231.00	$50.47 – $471.00
Therapeutic activities, 15 minutes CPT 97530	$44.62	$188.00	$63.79 – $471.00

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$177.99	$497.00	$66.10 – $483.53
Family psychotherapy, without the patient, 50 minutes CPT 90846	$177.99	$385.00	$51.21 – $374.57
Group psychotherapy CPT 90853	$102.47	$413.00	$54.93 – $401.81
Psychiatric diagnostic evaluation CPT 90791	$177.99	$790.00	$105.07 – $768.59
Psychotherapy, 30 minutes CPT 90832	$177.99	$452.00	$60.12 – $439.75
Psychotherapy, 45 minutes CPT 90834	$177.99	$539.00	$71.69 – $524.39
Psychotherapy, 60 minutes CPT 90837	$177.99	$605.00	$80.47 – $588.60

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$78.84	$1,987.00	$264.27 – $1,933.15
IV hydration, each additional hour CPT 96361	$51.11	$440.00	$58.52 – $428.08
IV hydration, first hour CPT 96360	$233.41	$1,430.00	$190.19 – $1,391.25
IV push injection of a drug, first CPT 96374	$233.41	$715.00	$95.10 – $695.62
IV push injection, each additional drug CPT 96375	$51.11	$461.00	$61.31 – $448.51

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	not posted	$1.39	? – $1.34
Fentanyl injection, per 0.1 mg HCPCS J3010	not posted	$4.06	? – $3.92
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted	$104.03	$16.12 – $100.49
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	not posted	$4.37	? – $4.22
Midazolam (Versed) injection, per 1 mg HCPCS J2250	not posted	$1.59	? – $1.54
Morphine injection, up to 10 mg HCPCS J2270	not posted	$20.13	$3.12 – $19.45
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	not posted	$1.60	? – $1.55
Saline IV solution, 1000 ml HCPCS J7030	not posted	$40.00	$6.20 – $38.64

Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.

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