CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: St Clair Hospital

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$25,612
about 1.1× the $23,504 Medicare rate · typically $19,802–$40,699
modeled estimate · not a bill or quote
What this hospital charges insurers
$40,095
Above the fair price
about $14,483 over the fair price · 1.7× Medicare
Medicare pays $23,504 Fair price $25,612 This hospital $40,095 Cash price $23,651 Hospital's list price $156,723

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 $40,095

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 $25,612 (about 1.1× the $23,504 Medicare rate). St Clair Hospital charges insurers about $40,095, or about $23,651 in cash — 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 $25,612. 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.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $22,834 - $41,272 97%
Blue Cross Blue Shieldmajor $20,585 - $40,095 88%
Aetnamajor $23,519 - $45,814 100%
Cignamajor $24,204 - $43,610 103%
Humanamajor $22,834 97%
AmeriHealth $22,834 97%
Geisinger $24,204 103%
HealthPartners $24,433 104%
UPMC Health Plan $24,302 - $34,908 103%
+ 2 smaller / regional plans $23,291 - $51,377

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.

Enter your details and press estimate to compare.

Facility Profile & Credentials

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