CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 99203 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$102
about 0.9× the $118 Medicare rate · typically $67–$216
modeled estimate · not a bill or quote
What this hospital charges insurers
$219
Well above the fair price
about $117 over the fair price · 1.9× Medicare
Medicare pays $118 Fair price $102 This hospital $219 Cash price $382 Hospital's list price $636

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 $219

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

A fair price for a New patient office visit (30-44 min) is about $102 (about 0.9× the $118 Medicare rate). UPMC Children's Hospital of Pittsburgh charges insurers about $219, or about $382 in cash — well 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 $102. 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.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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 $215 - $299 183%
Blue Cross Blue Shieldmajor $219 - $411 186%
Aetnamajor $90 - $350 77%
Cignamajor $64 - $350 54%
AmeriHealth $203 173%
Geisinger $223 - $286 190%
HealthPartners $210 179%
UPMC Health Plan $125 - $289 106%
+ 7 smaller / regional plans $220 - $572
Excludes 2 rental-network / third-party entries (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.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: One Children's Hospital Drive, Pittsburgh, PA 15224
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens