CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: UPMC Presbyterian Shadyside

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$73
about 0.8× the $95 Medicare rate · typically $59–$102
modeled estimate · not a bill or quote
What this hospital charges insurers
$58
Below the fair price — a good deal
about $15 under the fair price · 0.6× Medicare
Medicare pays $95 Fair price $73 This hospital $58 Cash price $148 Hospital's list price $246

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $25 Priciest $58

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $73 (about 0.8× the $95 Medicare rate). UPMC Presbyterian Shadyside charges insurers about $58, or about $148 in cash — below the fair price — a good deal. Located in Pittsburgh, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $42 44%
Blue Cross Blue Shieldmajor $52 - $302 55%
Aetnamajor $36 - $62 38%
Humanamajor $209 220%
AmeriHealth $55 58%
Fidelis Care $184 193%
Geisinger $54 57%
HealthPartners $53 56%
UPMC Health Plan $38 - $89 40%
+ 6 smaller / regional plans $60 - $209
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 200 Lothrop Street, Pittsburgh, PA 15213
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals