Children's Specialized Hospital
200 Somerset St, New Brunswick, NJ 08901 · 76 Priced Procedures
Typical commercial prices here are 4% below the fair benchmark (0.96×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Aligned Regional Benchmark Peer
Children's Specialized Hospital prices shoppable and inpatient services (1.2× to 0.8× Medicare, divergence 0.67×) in alignment with regional hospital peers (0.96× 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)
- Elective shoppable care is priced 4% below peer Fair BaseRate (0.96×)
- Self-pay cash beats commercial insurance on 88% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (76.4% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
- Commercial insurance median sits at 0.79× Fair BaseRate (1.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Specialty infusion drugs (J-codes) average 1.4× Medicare — verify per-unit billing on itemized statements
- Unnegotiated chargemaster list prices average 7.5× Medicare (30¢ true HCRIS cost per $1 gross)
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 Children's Specialized Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 76 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $573 | 2.1× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $544 | 1.1× |
| MRI, brain (no contrast) CPT Code: 70551 | $330 | 1.0× |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $289 | 2.3× |
| Speech therapy (language evaluation) CPT Code: 92507 | $251 | 2.9× |
| Psychological testing evaluation CPT Code: 96136 | $258 | 2.0× |
| X-ray, hand CPT Code: 73130 | $274 | unverified |
| X-ray, hip CPT Code: 73502 | $282 | unverified |
| Psychiatric evaluation (first visit) CPT Code: 90791 | $251 | 1.4× |
| Neurobehavioral status check CPT Code: 96116 | $252 | 1.1× |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $223 | 2.6× |
| Family therapy session CPT Code: 90847 | $226 | 1.3× |
| Psychotherapy session (45 minutes) CPT Code: 90834 | $216 | 1.3× |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $216 | 1.2× |
| X-ray, neck (cervical spine) CPT Code: 72040 | $208 | unverified |
| X-ray, lower back CPT Code: 72110 | $198 | unverified |
| CT scan, head (with and without contrast) CPT Code: 70470 | $172 | 0.7× |
| X-ray, shoulder CPT Code: 73030 | $176 | unverified |
| X-ray, ankle CPT Code: 73610 | $190 | unverified |
| X-ray, foot CPT Code: 73630 | $209 | unverified |
| Speech therapy (group session) CPT Code: 92508 | $170 | 6.3× |
| New patient office visit (30-44 min) CPT Code: 99203 | $176 | 1.6× |
| Group therapy session CPT Code: 90853 | $131 | 1.3× |
| CT scan, pelvis CPT Code: 72192 | $144 | 0.9× |
| CT scan, chest (no contrast) CPT Code: 71250 | $146 | 0.9× |
Audit a Bill or Quote at Children's Specialized Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $876
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (76.4% of gross = $876).
Self-Pay Cash Rate ($573) Beats Your Bill
Children's Specialized Hospital's published 45 CFR § 180 self-pay cash rate is $573 (vs. $573 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $272 Fair BaseRate ($244 Medicare)
Your bill ($1,146) is $874 above the denoised Fair BaseRate ($272) and 4.7× the $244 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (76.4% 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
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Children's Specialized Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-08-01·administrative_or_closure
Met Requirements
Recorded
Source: CMS Hospital Care Compare. 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 Children's Specialized Hospital.
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.