CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Raritan Bay Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $5,818
  • Cash Discount Price: $2,527
  • vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Raritan Bay Medical Center is $5,818. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,527. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 2.47x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$2,527

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,818

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2,357.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,357.81 (100%)
Cash / Self-Pay: $2,527 (107%)
Insurance Median: $5,818 (247%)
Cash: $2,527 (107% of Medicare)
Ins. Median: $5,818 (247% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2,357.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 247% of the Medicare baseline (a markup of 147%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $978 - $8,419 41%
Karna $1,164 49%
UnitedHealthcare $1,189 - $10,156 50%
Clover $1,323 56%
Seoul Medical Group $1,522 65%
Blue Cross Blue Shield $2,527 107%
Vaccn $2,527 107%
Wellcare $2,527 107%
Horizon $2,577 - $7,101 109%
United Community/Americhoice $2,653 113%
Amerigroup $2,704 115%
Activecare First McO $2,915 124%
Qualcare $5,366 - $6,469 228%
Bergen Risk $5,513 234%
Cigna $5,881 - $7,091 249%
Multiplan - PHCS $6,248 265%
Amerihealth $6,795 - $7,592 288%
Oxford $8,086 343%
Brighton Health Plan $9,933 421%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals