How many shoppable procedure prices are published for Robert Wood Johnson University Hospital - Somerset?

Robert Wood Johnson University Hospital - Somerset in Somerville, NJ currently has 131 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Robert Wood Johnson University Hospital - Somerset's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Robert Wood Johnson University Hospital - Somerset's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

What is Robert Wood Johnson University Hospital - Somerset's CMS Care Compare overall star rating?

CMS Care Compare assigns Robert Wood Johnson University Hospital - Somerset an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 332 Beds · urban Updated: 2026-03-04

Robert Wood Johnson University Hospital - Somerset

110 Rehill Ave, Somerville, NJ 08876 · 131 Priced Procedures · 67% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Above Fair Market · Negotiate

1.06×vs. Fair Market Price

Typical commercial prices here are +6% above the fair benchmark (1.06×) even after accounting for local nurse/doctor wages and patient complexity.

80/100 · Corroborated

80/100Self-Pay Cash Beats Insurance 58% of the Time

File Completeness51

Price Logic96

Peer Alignment64

Clean Billing89

Real Cash Discount100

Regional Value Leader

3-Star CMS clinical quality rating paired with 1.06× fair market pricing.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Robert Wood Johnson University Hospital - Somerset maintains elevated commercial insurance contracts (1.06× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 58% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#21 of 52 in NJ · 38th State Percentile#1,552 of 3,385 in U.S. · 45th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.96× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 58% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (63/100 safety score) with 67% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (14.8% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.1× markup over Medicare rates
Commercial insurance median sits at 1.03× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.32×) jump +28% above the median procedure ratio (Q50 1.03×)
Unnegotiated chargemaster list prices average 13.1× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.7× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.71× Divergence

1.2× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+28% Upper Tail

Q25 0.96× · Q50 1.03× · Q75 1.32×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

2.1× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

2.5× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

3.4× MedicareElevated

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.0× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

58% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 63/100Elevated

Procedure Prices at Robert Wood Johnson University Hospital - Somerset

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 131 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$2,486	$53,992	$30,775	1.8×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$2,486	$40,297	$17,936	unverified
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$2,486	$37,880	$19,087	2.0×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$2,486	$29,239	$19,432	1.5×
Total hip replacement CPT Code: `27130`	$6,311	$16,865	$13,413	1.3×
Total knee replacement CPT Code: `27447`	$6,311	$16,865	$13,523	1.2×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$2,486	$15,010	$8,223	1.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$6,311	$8,970	$6,109	1.5×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$6,311	$6,205	$3,372	unverified
Inguinal hernia repair CPT Code: `49505`	$6,311	$5,854	$3,629	unverified
Bunion correction surgery CPT Code: `28296`	$6,311	$5,036	$3,446	1.5×
Breast lump removal CPT Code: `19120`	$6,311	$5,036	$3,875	1.3×
Cataract surgery with lens implant CPT Code: `66984`	$6,311	$4,960	$2,540	unverified
Vaginal delivery (full package) CPT Code: `59400`	$6,311	$4,294	$2,680	1.6×
C-section delivery (full package) CPT Code: `59510`	$6,311	$4,294	$2,975	1.4×
Colonoscopy with biopsy CPT Code: `45380`	$6,311	$2,564	$1,256	2.0×
Injection procedure for pain management HCPCS Code: `G0260`	—	$2,363	$855	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$6,311	$2,039	$987	2.1×
Colonoscopy (diagnostic) CPT Code: `45378`	$6,311	$1,983	$981	2.0×
Trauma team activation HCPCS Code: `G0390`	—	$1,446	$1,453	1.0×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,315	$1,148	$1,021	1.1×
Hospital observation (per hour) HCPCS Code: `G0378`	$930	$930	$86	unverified
Blood transfusion CPT Code: `36430`	—	$836	$498	1.7×
MRI, brain (with and without contrast) CPT Code: `70553`	$851	$586	$511	1.1×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$745	$599	$583	1.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$469	$494	$272	1.8×
Behavioral health day treatment HCPCS Code: `H0010`	—	$453	$343	1.3×
Psychological testing by technician CPT Code: `96138`	—	$436	$395	1.1×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$609	$443	$448	1.0×
MRI, lower back (no contrast) CPT Code: `72148`	$482	$368	$338	1.1×
MRI, brain (no contrast) CPT Code: `70551`	$554	$368	$343	1.1×
MRI, knee or other leg joint CPT Code: `73721`	—	$387	$369	1.0×
Neurobehavioral status check CPT Code: `96116`	—	$340	$231	1.5×
CT scan, head (with and without contrast) CPT Code: `70470`	$496	$288	$258	1.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$514	$296	$303	1.0×
Rabies immune globulin HCPCS Code: `90375`	—	$306	$322	1.0×
CT scan, head (with contrast) CPT Code: `70460`	$390	$265	$242	1.1×
CT scan, pelvis CPT Code: `72192`	$341	$221	$163	1.4×
CT scan, sinuses CPT Code: `70486`	$552	$221	$166	1.3×
CT scan, chest (no contrast) CPT Code: `71250`	$568	$221	$167	1.3×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$622	$221	$168	1.3×
CT scan, neck (cervical spine) CPT Code: `72125`	$639	$205	$169	1.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$135	$225	$201	1.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	$184	$169	$134	1.3×
CT scan, head (no contrast) CPT Code: `70450`	$352	$186	$160	1.2×
Ultrasound, pelvis CPT Code: `76856`	$225	$152	$130	1.2×
Psychotherapy session (45 minutes) CPT Code: `90834`	$102	$176	$166	1.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$230	$149	$132	1.1×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$157	$151	1.0×
Family therapy session CPT Code: `90847`	$114	$176	$173	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$123	$176	$181	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$154	$176	$185	1.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$128	$25	5.1×
Physical therapy (gait training) CPT Code: `97116`	—	$125	$33	3.8×
Physical therapy (manual therapy) CPT Code: `97140`	—	$125	$34	3.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	—	$125	$35	3.6×
Physical therapy (functional capacity test) CPT Code: `97750`	—	$129	$38	3.4×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	—	$125	$38	3.3×
Occupational therapy (self-care training) CPT Code: `97535`	—	$125	$38	3.3×
Occupational therapy (therapeutic activities) CPT Code: `97530`	—	$129	$40	3.2×
Prosthetic fitting and training CPT Code: `97761`	—	$129	$45	2.9×
Orthotic fitting and training CPT Code: `97760`	—	$129	$51	2.5×
Speech therapy (language evaluation) CPT Code: `92507`	—	$125	$86	1.5×
Psychological testing evaluation CPT Code: `96136`	—	$141	$128	1.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	$159	$131	$126	1.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$132	$152	$148	1.0×
X-ray, lower back CPT Code: `72110`	$133	$116	$112	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$107	$126	$123	1.0×
X-ray, shoulder CPT Code: `73030`	—	$96	$92	1.0×
X-ray, foot CPT Code: `73630`	—	$96	$92	1.0×
X-ray, chest (two views) CPT Code: `71046`	$83	$96	$93	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$120	$96	$93	1.0×
X-ray, hand CPT Code: `73130`	—	$96	$93	1.0×
X-ray, hip CPT Code: `73502`	—	$96	$93	1.0×
X-ray, ankle CPT Code: `73610`	—	$96	$93	1.0×
X-ray, chest (single view) CPT Code: `71045`	$72	$93	$92	1.0×
Group therapy session CPT Code: `90853`	$111	$101	$100	1.0×
X-ray, pelvis CPT Code: `72170`	$105	$109	$110	1.0×
Office visit, established patient (30-39 min) CPT Code: `99214`	$95	$96	$123	0.8×
Residential mental health treatment HCPCS Code: `H2036`	—	$87	$406	0.2×
Typhoid vaccine HCPCS Code: `90675`	$188	$358	$347	1.0×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$208	$203	1.0×
Drug screening test HCPCS Code: `G0480`	$126	$114	$116	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$59	$133	$140	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$22	$106	$111	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$61	$66	$64	1.0×
Diagnostic procedure preparation HCPCS Code: `G0279`	$68	$40	$35	1.1×
Flu vaccine injection HCPCS Code: `G0008`	$29	$50	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$29	$50	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$29	$50	$49	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$87	$66	$87	0.8×
New patient office visit (30-44 min) CPT Code: `99203`	$98	$64	$110	0.6×
Community mental health services HCPCS Code: `H0038`	—	$18	$16	1.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$12	$11	$11	1.0×
Blood test, calcium CPT Code: `82310`	$6	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$6	$5	$5	1.0×
Blood test, vitamin D CPT Code: `82306`	$33	$30	$31	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$3	$3	$3	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$15	$14	$14	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$4	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$11	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$8	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$7	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$5	$5	$5	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$29	$26	$27	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$20	$18	$19	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$17	$15	$16	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$15	$13	$14	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$36	$39	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$9	$8	$9	0.9×
Blood test, liver function panel CPT Code: `80076`	$9	$8	$9	0.9×
Hepatitis B vaccine HCPCS Code: `90744`	$9	$32	$37	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$20	$41	$56	0.7×
Blood test, sodium CPT Code: `84295`	$5	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$4	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$9	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$7	$6	$6	1.0×
Culture, bacterial CPT Code: `87070`	$9	$9	$9	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$18	$17	$18	0.9×
Hepatitis C antibody test CPT Code: `86803`	$16	$14	$15	0.9×
Culture, blood CPT Code: `87040`	$11	$10	$11	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$8	$22	$25	0.9×
Care planning with family CPT Code: `90887`	—	$32	$107	0.3×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$5	$4	$5	0.8×
Blood test, hemoglobin CPT Code: `85018`	$3	$2	$3	0.7×
Mental health services (therapy) HCPCS Code: `H0032`	—	$25	$65	0.4×
Behavioral health assessment HCPCS Code: `H0001`	—	$49	$157	0.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$21	$19	$20	0.9×
Blood test, amylase CPT Code: `82150`	$7	$6	$7	0.9×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$17	$33	0.5×
Blood antibody screen CPT Code: `86850`	$11	$13	$46	0.3×

Showing top 25 high-impact procedures of 131 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 14.8%

Audit a Bill or Quote at Robert Wood Johnson University Hospital - Somerset (Zero PHI Required)

CMS CCN: 310048

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $2,486

Insurer Median $53,992

1. Amount on Your Bill or Quote ($) Pre-filled with Robert Wood Johnson University Hospital - Somerset’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $19,243 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $19,243

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (14.8% of gross = $19,243).

Step 2 · Cash vs. Insurance Arbitrage Save $127,095 Paying Cash

Self-Pay Cash Rate ($2,486) Beats Your Bill

Robert Wood Johnson University Hospital - Somerset's published 45 CFR § 180 self-pay cash rate is $2,486 (vs. $53,992 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$98,806 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($129,581) is $98,806 above the denoised Fair BaseRate ($30,775) and 5.5× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (14.8% 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.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite63/100

Would Recommend67%

Rated 9 or 10 (HCAHPS)70%

Median ER Wait184 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate4.1%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Robert Wood Johnson University Hospital - Somerset. Prior administrative notices do not necessarily reflect current compliance status.

2025-03-14·administrative_or_closure
Closure Notice
Recorded
2025-02-24·warning_notice
Warning Notice
Recorded
2023-06-29·administrative_or_closure
Closure Notice
Recorded
2023-03-17·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (1,433 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Robert Wood Johnson University Hospital - Somerset.

Price Index: 0.88× regional baseline

Quality: 59/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

WellCare

+70.5%

Median Household Income$135,960U.S. Census ACS

Local Uninsured Share5.7%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 80/100 · Corroborated CMS CCN 310048

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 310048) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-04

Validated Rate Rows3,286 (CMS v3.0.0)

File Integrity DigestVerified · CCN 310048

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.

Submit MRF Update Correction Policy