CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: St Clair Hospital

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$97
about 0.7× the $136 Medicare rate · typically $79–$135
modeled estimate · not a bill or quote
What this hospital charges insurers
$63
Below the fair price — a good deal
about $34 under the fair price · 0.5× Medicare
Medicare pays $136 Fair price $97 This hospital $63 Cash price $27 Hospital's list price $109

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

On the higher side — 7 of 8 other PA hospitals charge less.

Cheapest $25 Priciest $64

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 (30-39 min) is about $97 (about 0.7× the $136 Medicare rate). St Clair Hospital charges insurers about $63, or about $27 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.

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 $57 42%
Blue Cross Blue Shieldmajor $63 46%
Aetnamajor $63 46%
AmeriHealth $63 46%
Geisinger $63 46%
HealthPartners $63 46%
UPMC Health Plan $33 - $121 24%
+ 1 smaller / regional plan $63

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 1000 Bower Hill Road, Pittsburgh, PA 15243
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals