How many shoppable procedure prices are published for St Louis Childrens Hospital?

St Louis Childrens Hospital in Saint Louis, MO currently has 96 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do St Louis Childrens Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, St Louis Childrens Hospital's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Children's Hospital Voluntary non-profit - Other 455 Beds · urban Updated: 2025-12-15

St Louis Childrens Hospital

One Childrens Place, Saint Louis, MO 63110 · 96 Priced Procedures

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.07×vs. Fair Market Price

Typical commercial prices here are +7% above the fair benchmark (1.07×) even after accounting for local nurse/doctor wages and patient complexity.

82/100 · Corroborated

82/100Self-Pay Cash Beats Insurance 68% of the Time

File Completeness66

Price Logic93

Peer Alignment66

Clean Billing86

Real Cash Discount100

High-Markup 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

St Louis Childrens Hospital maintains elevated commercial insurance contracts (1.07× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 68% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#40 of 79 in MO · 49th State Percentile#1,588 of 3,385 in U.S. · 46th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.81× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 68% 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 (58.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.07× 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 0.92× Fair BaseRate (1.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
Even at low-cost facilities (1.07× 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 10.2× Medicare (23¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.0× Medicare

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

Back-Door Captive & ER1.00× Divergence

1.0× Medicare

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

Quantile Tail Spread+7% Upper Tail

Q25 0.81× · Q50 0.92× · Q75 0.98×

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

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.9× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.7× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.6× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.7× MedicareGood

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

0.6× MedicareGood

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

68% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at St Louis Childrens Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 96 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`	$77,688	$77,688	$30,775	unverified
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$42,201	$42,201	$19,087	2.2×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$13,122	$13,122	$8,223	1.6×
Inguinal hernia repair CPT Code: `49505`	$7,261	$7,261	$3,629	2.0×
Trauma team activation HCPCS Code: `G0390`	$7,092	$7,092	$1,453	4.9×
MRI, knee or other leg joint CPT Code: `73721`	$3,327	$3,327	$369	9.0×
Upper endoscopy with biopsy CPT Code: `43239`	$8,732	$1,889	$987	1.9×
Colonoscopy with biopsy CPT Code: `45380`	$8,766	$1,178	$1,256	0.9×
Hepatitis B immune globulin HCPCS Code: `90371`	$1,072	$1,072	$151	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$4,381	$845	$1,021	0.8×
Injection procedure for pain management HCPCS Code: `G0260`	$16,473	$695	$855	0.8×
Colonoscopy (diagnostic) CPT Code: `45378`	$5,766	$650	$981	0.7×
X-ray, hand CPT Code: `73130`	$523	$523	$93	5.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,154	$538	$583	0.9×
X-ray, shoulder CPT Code: `73030`	$433	$433	$92	4.7×
Blood transfusion CPT Code: `36430`	$1,084	$434	$498	0.9×
X-ray, foot CPT Code: `73630`	$383	$383	$92	4.2×
Hospital observation (per hour) HCPCS Code: `G0378`	$344	$344	$86	4.0×
X-ray, ankle CPT Code: `73610`	$367	$367	$93	3.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,680	$343	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$4,651	$343	$511	0.7×
Rabies immune globulin HCPCS Code: `90375`	$1,147	$287	$322	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$158	$216	$201	1.1×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$628	$235	$272	0.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,420	$235	$303	0.8×
MRI, lower back (no contrast) CPT Code: `72148`	$3,476	$235	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$3,385	$235	$343	0.7×
Speech therapy (group session) CPT Code: `92508`	$176	$176	$27	6.5×
CT scan, head (with contrast) CPT Code: `70460`	$866	$173	$242	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$964	$173	$258	0.7×
X-ray, pelvis CPT Code: `72170`	$422	$103	$110	0.9×
X-ray, chest (single view) CPT Code: `71045`	$249	$86	$92	0.9×
X-ray, chest (two views) CPT Code: `71046`	$341	$86	$93	0.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$181	$86	$93	0.9×
X-ray, hip CPT Code: `73502`	$179	$86	$93	0.9×
X-ray, lower back CPT Code: `72110`	$583	$103	$112	0.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$285	$103	$126	0.8×
Ultrasound, pelvis CPT Code: `76856`	$309	$103	$130	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,118	$103	$132	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,084	$103	$134	0.8×
CT scan, head (no contrast) CPT Code: `70450`	$739	$103	$160	0.6×
CT scan, pelvis CPT Code: `72192`	$697	$103	$163	0.6×
CT scan, sinuses CPT Code: `70486`	$675	$103	$166	0.6×
CT scan, chest (no contrast) CPT Code: `71250`	$817	$103	$167	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,289	$103	$168	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$693	$103	$169	0.6×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$274	$394	$111	unverified
Typhoid vaccine HCPCS Code: `90675`	$1,091	$328	$347	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$128	$151	$56	unverified
Drug screening test HCPCS Code: `G0480`	$120	$117	$116	1.0×
Blood antibody screen CPT Code: `86850`	$66	$51	$46	1.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$227	$58	$64	0.9×
Speech therapy (language evaluation) CPT Code: `92507`	$465	$74	$86	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$73	$73	$39	unverified
Flu vaccine injection HCPCS Code: `G0008`	$85	$46	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$85	$46	$49	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	$85	$46	$49	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$67	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$210	$11	$11	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$185	$14	$14	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$16	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$35	$7	$7	1.0×
Blood test, calcium CPT Code: `82310`	$44	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$22	$5	$5	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$168	$14	$14	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$28	$20	$20	1.0×
Blood test, vitamin D CPT Code: `82306`	$326	$30	$31	1.0×
Orthotic fitting and training CPT Code: `97760`	$97	$45	$51	0.9×
Blood test, glucose (blood sugar) CPT Code: `82947`	$17	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$97	$10	$10	1.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$101	$12	$14	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$90	$34	$40	0.8×
Physical therapy (gait training) CPT Code: `97116`	$69	$28	$33	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$121	$32	$38	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$139	$31	$38	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$60	$31	$38	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$133	$28	$35	0.8×
Flu vaccine (high dose) HCPCS Code: `90656`	$47	$47	$25	unverified
Hepatitis B vaccine HCPCS Code: `90744`	$67	$67	$37	unverified
Blood test, lipase CPT Code: `83690`	$28	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$31	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$18	$5	$5	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$28	$19	$19	1.0×
Blood test, sodium CPT Code: `84295`	$18	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$35	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$26	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$24	$6	$6	1.0×
Hepatitis C antibody test CPT Code: `86803`	$58	$15	$15	1.0×
Culture, blood CPT Code: `87040`	$67	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	$49	$9	$9	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$167	$17	$18	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$175	$15	$16	0.9×
Blood test, liver function panel CPT Code: `80076`	$218	$8	$9	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$25	$4	$5	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$107	$27	$34	0.8×
Blood test, hemoglobin CPT Code: `85018`	$13	$2	$3	0.7×

Showing top 25 high-impact procedures of 96 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 58.0%

Audit a Bill or Quote at St Louis Childrens Hospital (Zero PHI Required)

CMS CCN: 263301

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $77,688

Insurer Median $77,688

1. Amount on Your Bill or Quote ($) Pre-filled with St Louis Childrens Hospital’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: $75,098 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $75,098

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (58.0% of gross = $75,098).

Step 2 · Cash vs. Insurance Arbitrage Save $51,792 Paying Cash

Self-Pay Cash Rate ($77,688) Beats Your Bill

St Louis Childrens Hospital's published 45 CFR § 180 self-pay cash rate is $77,688 (vs. $77,688 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$98,705 Above Fair BaseRate

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

Your bill ($129,480) is $98,705 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)

EIN: 430654870

Filing Period: 200203

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 (58.0% 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 ↑

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

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

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for St Louis Childrens Hospital.

Price Index: 1.50× regional baseline

Quality: 54/100 CMS composite

Median Household Income$55,279U.S. Census ACS

Local Uninsured Share9.3%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 82/100 · Corroborated CMS CCN 263301 EIN 430654870

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 263301) ↗ Verify IRS Form 990 (EIN 430654870) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2025-12-15

Validated Rate Rows6,466 (CMS v3.0.0)

File Integrity DigestVerified · CCN 263301

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