How many shoppable procedure prices are published for Saint Barnabas Behavioral Health Center?

Saint Barnabas Behavioral Health Center in Toms River, NJ currently has 47 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Saint Barnabas Behavioral Health Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Saint Barnabas Behavioral Health Center's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Psychiatric Hospital Voluntary non-profit - Private 40 Beds · urban Updated: 2026-03-04

Saint Barnabas Behavioral Health Center

1691 Highway 9 - Cn2025, Toms River, NJ 08755 · 47 Priced Procedures

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.11×vs. Fair Market Price

Typical commercial prices here are +11% above the fair benchmark (1.11×) even after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 64% of the Time

File Completeness56

Price Logic100

Peer Alignment60

Clean Billing77

Real Cash Discount100

Premium Quality Tier

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Saint Barnabas Behavioral Health Center maintains elevated commercial insurance contracts (1.11× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 64% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#32 of 52 in NJ · 59th State Percentile#1,716 of 3,385 in U.S. · 50th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.95× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 64% 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 (57.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.1× markup over Medicare rates
Captive ER (1.3×) & laboratory (2.7×) services average 1.11× higher multiples than routine shoppable care (0.9×)
Even at low-cost facilities (1.11× 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.
Unnegotiated chargemaster list prices average 13.2× Medicare (21¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.9× Medicare

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

Back-Door Captive & ER1.11× Divergence

1.0× Medicare

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

Quantile Tail Spread+4% Upper Tail

Q25 0.95× · Q50 0.97× · Q75 1.01×

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

0.9× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.1× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.0× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.3× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.7× MedicareFair

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

1.0× MedicareGood

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

64% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Saint Barnabas Behavioral Health Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 47 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Family therapy session CPT Code: `90847`	$264	$176	$173	1.0×
Psychotherapy session (45 minutes) CPT Code: `90834`	$146	$167	$166	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$163	$176	$181	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$249	$176	$185	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$100	$100	$64	1.6×
Typhoid vaccine HCPCS Code: `90675`	$402	$402	$347	1.2×
Blood test, vitamin D CPT Code: `82306`	$180	$180	$31	5.8×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$171	$171	$203	0.8×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$116	$116	$11	10.5×
Culture, blood CPT Code: `87040`	$102	$102	$11	9.3×
Blood test, PSA (prostate screen) CPT Code: `84153`	$108	$108	$19	5.7×
Flu vaccine injection HCPCS Code: `G0008`	$109	$109	$48	2.3×
Pneumococcal vaccine HCPCS Code: `90732`	$127	$127	$140	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$90	$90	$18	5.0×
Blood test, magnesium CPT Code: `83735`	$55	$55	$7	7.9×
Blood test, basic metabolic panel CPT Code: `80048`	$62	$62	$9	6.9×
Blood test, liver function panel CPT Code: `80076`	$61	$61	$9	6.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$85	$85	$14	6.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	$109	$109	$49	2.2×
Colorectal cancer screening HCPCS Code: `G0010`	$109	$109	$49	2.2×
Physical therapy (gait training) CPT Code: `97116`	$76	$76	$33	2.3×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$76	$76	$35	2.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$33	$33	$5	6.6×
Blood test, complete blood count (CBC) CPT Code: `85025`	$50	$50	$8	6.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$67	$67	$14	4.8×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$33	$33	$3	11.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$44	$44	$6	7.3×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$57	$57	$10	5.7×
Culture, bacterial CPT Code: `87070`	$47	$47	$9	5.2×
Hepatitis C antibody test CPT Code: `86803`	$58	$58	$15	3.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$76	$76	$40	1.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$49	$49	$39	1.3×
Blood test, hemoglobin CPT Code: `85018`	$21	$21	$3	7.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$23	$23	$5	4.6×
Blood test, amylase CPT Code: `82150`	$30	$30	$7	4.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$43	$43	$56	0.8×
Group therapy session CPT Code: `90853`	$118	$44	$100	0.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$46	$46	$111	0.4×
Blood test, glucose (blood sugar) CPT Code: `82947`	$16	$16	$4	4.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$15	$15	$4	3.8×
Blood test, potassium CPT Code: `84132`	$18	$18	$5	3.6×
Blood test, lipase CPT Code: `83690`	$25	$25	$7	3.6×
Blood test, calcium CPT Code: `82310`	$15	$15	$5	3.0×
Blood test, sodium CPT Code: `84295`	$13	$13	$5	2.6×
Blood test, vitamin B12 CPT Code: `82607`	$36	$36	$16	2.3×
Flu vaccine (high dose) HCPCS Code: `90656`	$13	$13	$25	0.5×
Hepatitis B vaccine HCPCS Code: `90744`	$19	$19	$37	0.5×

Showing top 25 high-impact procedures of 47 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 57.0%

Audit a Bill or Quote at Saint Barnabas Behavioral Health Center (Zero PHI Required)

CMS CCN: 314022

CPT 90847

Select Procedure to Audit:

Fair BaseRate™ $173

Medicare Rate $181

Self-Pay Cash $264

Insurer Median $176

1. Amount on Your Bill or Quote ($) Pre-filled with Saint Barnabas Behavioral Health Center’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: $417 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $417

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (57.0% of gross = $417).

Step 2 · Cash vs. Insurance Arbitrage Save $467 Paying Cash

Self-Pay Cash Rate ($264) Beats Your Bill

Saint Barnabas Behavioral Health Center's published 45 CFR § 180 self-pay cash rate is $264 (vs. $176 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$558 Above Fair BaseRate

Negotiate Toward $173 Fair BaseRate ($181 Medicare)

Your bill ($731) is $558 above the denoised Fair BaseRate ($173) and 4.0× the $181 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 (57.0% 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.

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 Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Saint Barnabas Behavioral Health Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-09-16·administrative_or_closure
Closure Notice
Recorded
2025-08-05·cap_corrective_action
CAP Request
Recorded

Source: CMS Hospital Care Compare. 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

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Saint Barnabas Behavioral Health Center.

Price Index: 1.52× regional baseline

Quality: 54/100 CMS composite

Median Household Income$86,411U.S. Census ACS

Local Uninsured Share4.2%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 79/100 · Corroborated CMS CCN 314022

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 314022) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-04

Validated Rate Rows340 (CMS v3.0.0)

File Integrity DigestVerified · CCN 314022

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