CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: UPMC Presbyterian Shadyside

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$27,937
about 1.2× the $23,504 Medicare rate · typically $20,723–$35,608
modeled estimate · not a bill or quote
What this hospital charges insurers
$33,238
Above the fair price
about $5,301 over the fair price · 1.4× Medicare
Medicare pays $23,504 Fair price $27,937 This hospital $33,238

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 $11,459 Priciest $33,238

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

A fair price for a Spinal fusion, single level (inpatient stay) is about $27,937 (about 1.2× the $23,504 Medicare rate). UPMC Presbyterian Shadyside charges insurers about $33,238 — above the fair price. Located in Pittsburgh, PA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $27,937. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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 $32,933 140%
Blue Cross Blue Shieldmajor $30,494 - $110,736 130%
Aetnamajor $33,543 143%
AmeriHealth $32,933 140%
UPMC Health Plan $10,293 - $38,879 44%
+ 1 smaller / regional plan $32,933
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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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