Capital Health Regional Medical Center
750 Brunswick Ave, Trenton, NJ 08638 · 123 Priced Procedures · 51% Patient Recommendation
Typical commercial prices here are +5% above the fair benchmark (1.05×) even after accounting for local nurse/doctor wages and patient complexity.
2-Star CMS clinical quality rating paired with 1.05× fair market pricing.
Aligned Regional Benchmark Peer
Capital Health Regional Medical Center prices shoppable and inpatient services (1.4× to 1.1× Medicare, divergence 0.79×) in alignment with regional hospital peers (1.05× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.97× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 12% of shoppable procedures (25/100 Cash Honesty)
- 2-Star CMS clinical rating with 51% patient recommendation (57/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (10.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.05× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Commercial insurance median sits at 1.05× Fair BaseRate (1.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (1.05× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Consolidated metro market (HHI 3,448) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Capital Health Regional Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 123 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $37,842 | 1.2× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $32,252 | 1.7× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $31,775 | 1.7× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $23,089 | 1.3× |
| Total hip replacement CPT Code: 27130 | $14,062 | 1.0× |
| Total knee replacement CPT Code: 27447 | $14,062 | 1.0× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $13,034 | 1.6× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $6,376 | 1.0× |
| Breast lump removal CPT Code: 19120 | $4,185 | 1.1× |
| Inguinal hernia repair CPT Code: 49505 | $3,857 | 1.1× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $3,546 | 1.1× |
| Bunion correction surgery CPT Code: 28296 | $3,546 | 1.0× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,493 | 1.0× |
| Injection procedure for pain management HCPCS Code: G0260 | $1,655 | 1.9× |
| Trauma team activation HCPCS Code: G0390 | $1,500 | 1.0× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,289 | 1.0× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,112 | 1.1× |
| Hospital observation (per hour) HCPCS Code: G0378 | $1,128 | unverified |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,057 | 1.1× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,025 | 1.0× |
| Electrical stimulation therapy HCPCS Code: G0283 | $865 | 61.8× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $615 | 1.1× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $531 | 1.0× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $476 | 1.1× |
| Blood transfusion CPT Code: 36430 | $496 | 1.0× |
Audit a Bill or Quote at Capital Health Regional Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $9,046
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (10.0% of gross = $9,046).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Capital Health Regional Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($90,821) is $60,046 above the denoised Fair BaseRate ($30,775) and 3.9× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (10.0% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Capital Health Regional Medical Center. Prior administrative notices do not necessarily reflect current compliance status.
- 2026-04-09·administrative_or_closure
Met Requirements
Recorded - 2025-06-26·administrative_or_closure
Closure Notice
Recorded - 2025-05-14·cap_corrective_action
CAP Request
Recorded - 2025-02-11·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (619 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Capital Health Regional Medical Center.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.