Children's Home of Pittsburgh
5324 Penn Avenue, Pittsburgh, PA 15224 · 16 Priced Procedures
Typical commercial prices here are 51% below the fair benchmark (0.49×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Uniform Value Leader · Low-Cost Across Departments
Children's Home of Pittsburgh maintains low, disciplined commercial pricing across both routine shoppable procedures (0.5× Medicare, p50 0.49× Fair BaseRate) and emergency/ancillary services (0.5× Medicare, p75 0.54× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 51% below peer Fair BaseRate (0.49×)
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (25/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (23.6% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.49× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Commercial insurance median sits at 0.49× Fair BaseRate (0.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Specialty infusion drugs (J-codes) average 1.1× Medicare — verify per-unit billing on itemized statements
- Unnegotiated chargemaster list prices average 4.1× Medicare (22¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Children's Home of Pittsburgh
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 16 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Varicella (chickenpox) vaccine HCPCS Code: 90716 | — | — |
| Pneumococcal vaccine HCPCS Code: 90732 | — | — |
| MMR vaccine (measles, mumps, rubella) HCPCS Code: 90707 | — | — |
| Physical therapy (manual therapy) CPT Code: 97140 | $71 | 2.1× |
| Occupational therapy (self-care training) CPT Code: 97535 | $71 | 1.9× |
| Physical therapy (functional capacity test) CPT Code: 97750 | $71 | 1.9× |
| Orthotic fitting and training CPT Code: 97760 | $42 | 0.8× |
| Physical therapy (gait training) CPT Code: 97116 | $24 | 0.7× |
| Speech therapy (language evaluation) CPT Code: 92507 | $46 | 0.5× |
| Blood transfusion CPT Code: 36430 | $45 | 0.1× |
| Physical therapy (neuromuscular re-education) CPT Code: 97112 | $18 | 0.5× |
| Occupational therapy (therapeutic activities) CPT Code: 97530 | $14 | 0.3× |
| DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: 90700 | — | — |
| Hepatitis B vaccine HCPCS Code: 90744 | — | — |
| Physical therapy (therapeutic exercise) CPT Code: 97110 | $9 | 0.3× |
| Speech therapy (group session) CPT Code: 92508 | $10 | unverified |
Audit a Bill or Quote at Children's Home of Pittsburgh (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $43
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (23.6% of gross = $43).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Children's Home of Pittsburgh's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $203 Fair BaseRate ($118 Medicare)
Your entered amount is at or below the modeled Fair BaseRate benchmark ($203).
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (23.6% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Children's Home of Pittsburgh.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.