CMS Price Transparency Data

CT scan, sinuses

Facility: Capital Health Regional Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $983
  • Cash Discount Price: $18,495
  • vs. Medicare Baseline: 9.20x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Capital Health Regional Medical Center is $983. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,495. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.20x the Medicare baseline. Located in 750 Brunswick Ave, Trenton, NJ.
Cash / Self-Pay
$18,495

Average discount available for prompt cash payment at this facility.

Insurance Median
$983

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $18,495 (17316%)
Insurance Median: $983 (920%)
Cash: $18,495 (17316% of Medicare)
Ins. Median: $983 (920% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 920% of the Medicare baseline (a markup of 820%). 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
UnitedHealthcare $68 - $895 64%
Medicaid / KanCare $72 - $956 67%
Wellpoint $73 - $967 68%
Aetna $92 - $7,945 86%
Fidelis $116 109%
Clover $118 110%
Humana $120 112%
Medicare (plans) $120 112%
Blue Cross Blue Shield $169 - $2,677 158%
Cigna $241 - $16,785 226%
Oxford Benefit Plan $252 236%
Multiplan $1,441 - $19,023 1349%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 750 Brunswick Ave, Trenton, NJ 08638
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals