Learn Hardcore Indonesian: Menurut saya, biaya layanan di rumah sakit baru itu terlalu mahal. - In my opinion, the service fee at that new hospital is too expensive.

At the start: Menurut saya, biaya…
Parenthetical: Biaya…, menurut saya, terlalu…
At the end: Biaya… terlalu mahal, menurut saya. All are natural; sentence-initial is most common.

Do I need the comma after Menurut saya?

It’s recommended when Menurut saya is fronted, because it sets off an introductory phrase. In casual writing, people sometimes omit it, but the comma is standard and clearer.

How is menurut saya different from saya pikir, saya rasa, bagi/buat saya, pendapat saya, or sepertinya?

menurut saya: neutral, “in my opinion,” commonly used in speech and writing.
saya pikir: “I think,” slightly more cognitive/intellectual.
saya rasa: “I feel,” softer, hedging.
bagi/buat saya: “for me,” frames it as personal preference/standard, not necessarily an opinion judgment.
pendapat saya: “my opinion is…,” more formal/explicit.
sepertinya: “it seems,” impersonal hedge (you can add menurut saya for clarity).

What exactly does biaya layanan mean? Would other words fit better in a hospital context?

Biaya layanan = “service fees/costs.” In healthcare you’ll also see:

biaya perawatan: treatment/care costs.
biaya pengobatan: medical treatment/medication costs.
tarif (layanan/kamar/dokter): posted rates/price schedule.
harga: price (common with items like harga obat), less so for overall service fees.
ongkos: cost/fare; informal; rare in hospital billing. Your sentence is fine; depending on focus, biaya perawatan or tarif layanan may sound even more “hospital-like.”

What does di indicate here? Could I use ke or pada instead?

di marks location (“at/in”): di rumah sakit = “at the hospital.”

ke is movement (“to”): ke rumah sakit = “to the hospital.”
pada is used with recipients/abstracts and in formal style; with physical locations, di is the natural choice. So use di here.

Why is it rumah sakit baru itu and not itu rumah sakit baru or rumah sakit itu baru?

In noun phrases, Indonesian places modifiers after the noun, and the demonstrative (itu/ini) comes after the whole noun phrase:

rumah sakit baru itu = “that new hospital” (NP: [rumah sakit + baru] + itu).
itu rumah sakit baru = “that is a new hospital” (clause, itu = “that” as a pronoun).
rumah sakit itu baru = “that hospital is new” (clause with predicate adjective).

Can I say rumah sakit yang baru itu?

Yes. rumah sakit yang baru itu is also grammatical and can add a slightly more explicit “the one that is new” feel. Without yang, rumah sakit baru itu is already the default way to say “that new hospital.”

Does baru here mean “new” or “just”?

“New.” In noun phrases, baru after a noun is the adjective “new” (rumah sakit baru = “new hospital”). baru means “just/only recently” when it modifies a verb/verb phrase (e.g., baru buka = “just opened”).

Why not say adalah before terlalu mahal?

Indonesian typically doesn’t use adalah before adjectives. Adalah links a subject to a noun/noun phrase (e.g., Biaya… adalah masalah besar). With an adjective predicate like terlalu mahal, you just state it directly.

What’s the nuance of terlalu mahal vs sangat mahal, mahal sekali, mahal banget, agak/cukup mahal?

terlalu mahal: “too expensive” (excessive; negative evaluation).
sangat mahal / mahal sekali: “very expensive” (strong but not necessarily “too much”).
mahal banget: very informal “super expensive.”
agak mahal: “somewhat/a bit expensive” (softens).
cukup mahal / lumayan mahal: “quite/fairly expensive.”
Colloquial: Harganya kemahalan = “It’s overpriced.”

Do we need itu? What changes if we drop it or use ini/tersebut?

With itu: definite, known/previously mentioned or contextually specific (“that new hospital”).
Without it: indefinite (“a new hospital,” unspecific).
ini: “this new hospital” (near/just mentioned).
tersebut: formal “the aforementioned” (rumah sakit baru tersebut).

Can I replace the long noun phrase with -nya, like biayanya?

Yes, if the referent is clear from context:

Menurut saya, biayanya terlalu mahal. = “In my opinion, the cost is too expensive.”
Here -nya makes “the cost” definite (the cost under discussion).

Is rumah sakit singular or plural here?

Unmarked for number; context decides. With itu, it’s normally understood as singular (“that new hospital”). To force plural you can use reduplication (rumah sakit-rumah sakit baru itu) or a quantifier (beberapa rumah sakit baru). In formal writing, tersebut can be singular or plural from context.

Could I use tinggi instead of mahal for costs?

Yes, especially in formal contexts: Biaya… terlalu tinggi = “the costs are too high.” mahal is the everyday adjective for price/expense; tinggi sounds slightly more formal/neutral when talking about levels.

How could I soften or formalize the sentence?

Softer: Menurut saya, biayanya agak/cukup mahal.
Very polite/formal: Menurut saya, tarif layanannya relatif tinggi.
Informal: Menurut saya, biayanya mahal banget.

Is there any difference between layanan and pelayanan?

They’re closely related and often interchangeable. Subtlety:

layanan: “service” as an offering/output.
pelayanan: “service/servicing” emphasizing the process/act of serving; tends to sound a bit more formal/institutional.
Hospitals commonly use both: biaya pelayanan, tarif layanan, pelayanan pasien, etc.