How many shoppable procedure prices are published for Forbes Hospital?

Forbes Hospital in Monroeville, PA currently has 134 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Forbes Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Forbes Hospital's median negotiated commercial rate is 0.8× the regionally adjusted fair BaseRate benchmark.

What is Forbes Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Forbes Hospital an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 233 Beds · urban Updated: 2026-04-14

Forbes Hospital

2570 Haymaker Road, Monroeville, PA 15146 · 134 Priced Procedures · 69% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Good Deal · Below Fair Market

0.81×vs. Fair Market Price

Typical commercial prices here are 19% below the fair benchmark (0.81×) after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 16% of the Time

File Completeness56

Price Logic89

Peer Alignment66

Clean Billing85

Real Cash Discount100

Regional Benchmark Tier

3-Star CMS clinical quality rating paired with 0.81× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Forbes Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (0.7× Medicare, p50 0.79× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.96× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#13 of 134 in PA · 8th State Percentile#315 of 3,385 in U.S. · 9th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 19% below peer Fair BaseRate (0.81×)
Self-pay cash beats commercial insurance on 16% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (59/100 safety score) with 69% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (11.3% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.81× 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.
Captive ER (0.7×) & laboratory (1.2×) services average 1.43× higher multiples than routine shoppable care (0.7×)
Upper-quartile procedures (Q75 0.96×) jump +22% above the median procedure ratio (Q50 0.79×)
Unnegotiated chargemaster list prices average 5.9× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.7× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.43× Divergence

1.0× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+22% Upper Tail

Q25 0.57× · Q50 0.79× · Q75 0.96×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

0.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.2× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.7× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

16% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 59/100Elevated

Procedure Prices at Forbes Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 134 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$23,401	$30,775	0.8×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$14,881	$19,087	0.8×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$14,432	$19,432	0.7×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$13,783	$17,936	0.8×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$5,907	$8,223	0.7×
C-section delivery (full package) CPT Code: `59510`	$1,654	$3,101	$2,975	1.0×
Vaginal delivery (full package) CPT Code: `59400`	$1,489	$3,101	$2,680	unverified
Trauma team activation HCPCS Code: `G0390`	$4,180	$1,362	$1,453	0.9×
Blood transfusion CPT Code: `36430`	$1,228	$1,228	$498	2.5×
Cataract surgery with lens implant CPT Code: `66984`	$329	$851	$2,540	0.3×
Total hip replacement CPT Code: `27130`	$796	$796	$13,413	0.1×
Total knee replacement CPT Code: `27447`	$795	$795	$13,523	0.1×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$338	$750	$3,372	0.2×
Bunion correction surgery CPT Code: `28296`	$322	$571	$3,446	0.2×
Inguinal hernia repair CPT Code: `49505`	$326	$564	$3,629	0.2×
Breast lump removal CPT Code: `19120`	$260	$510	$3,875	0.1×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$411	$411	$6,109	0.1×
Colonoscopy with biopsy CPT Code: `45380`	$123	$361	$1,256	0.3×
Rabies immune globulin HCPCS Code: `90375`	$898	$309	$322	1.0×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,760	$329	$511	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,635	$308	$448	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	$113	$262	$981	0.3×
MRI, knee or other leg joint CPT Code: `73721`	$2,037	$214	$369	0.6×
Upper endoscopy with biopsy CPT Code: `43239`	$84	$238	$987	0.2×
MRI, brain (no contrast) CPT Code: `70551`	$2,037	$205	$343	0.6×
MRI, lower back (no contrast) CPT Code: `72148`	$2,037	$200	$338	0.6×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$167	$167	$64	2.6×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$849	$191	$272	0.7×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,461	$162	$303	0.5×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,540	$169	$583	0.3×
Hepatitis B immune globulin HCPCS Code: `90371`	$212	$143	$151	0.9×
Behavioral health assessment HCPCS Code: `H0001`	—	$140	$157	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,265	$158	$258	unverified
Diagnostic mammogram (both breasts) CPT Code: `77066`	$429	$132	$148	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$87	$131	$181	0.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$560	$104	$132	0.8×
Psychiatric evaluation (first visit) CPT Code: `90791`	$92	$123	$185	0.7×
Care planning with family CPT Code: `90887`	$47	$86	$107	0.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$554	$93	$123	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$560	$97	$134	0.7×
Review of medical records for care CPT Code: `90889`	—	$81	$114	0.7×
Ultrasound, pelvis CPT Code: `76856`	$560	$91	$130	0.7×
CT scan, sinuses CPT Code: `70486`	$1,083	$113	$166	0.7×
CT scan, pelvis CPT Code: `72192`	$1,083	$106	$163	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	$1,083	$106	$167	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,083	$107	$169	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,083	$106	$168	0.6×
CT scan, head (with contrast) CPT Code: `70460`	$1,812	$128	$242	0.5×
CT scan, head (no contrast) CPT Code: `70450`	$1,083	$100	$160	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	$59	$95	$166	0.6×
Family therapy session CPT Code: `90847`	$66	$88	$173	0.5×
Neurobehavioral status check CPT Code: `96116`	$49	$95	$231	0.4×
Screening mammogram (both breasts) CPT Code: `77067`	$352	$109	$123	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$115	$115	$86	unverified
Typhoid vaccine HCPCS Code: `90675`	$179	$396	$347	1.1×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$145	$225	$203	1.1×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$80	$115	$111	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$190	$140	$140	1.0×
Drug screening test HCPCS Code: `G0480`	—	$106	$116	0.9×
Speech therapy (language evaluation) CPT Code: `92507`	$295	$78	$86	0.9×
New patient office visit (30-44 min) CPT Code: `99203`	$475	$79	$110	0.7×
Ultrasound, abdomen (limited) CPT Code: `76705`	$560	$74	$126	0.6×
Sleep study (overnight, in lab) CPT Code: `95810`	$72	$72	$1,021	0.1×
Blood test, vitamin D CPT Code: `82306`	$186	$31	$31	1.0×
Extended office visit (prolonged) HCPCS Code: `G2212`	$19	$33	$33	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	$21	$35	$37	0.9×
Orthotic fitting and training CPT Code: `97760`	$174	$45	$51	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$66	$49	$56	0.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$475	$70	$87	0.8×
Injection procedure for pain management HCPCS Code: `G0260`	$75	$75	$855	0.1×
X-ray, hip CPT Code: `73502`	$425	$45	$93	0.5×
X-ray, lower back CPT Code: `72110`	$513	$48	$112	0.4×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$12	$42	$39	unverified
Blood test, ferritin (iron stores) CPT Code: `82728`	$87	$14	$14	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$425	$35	$93	0.4×
Blood test, glucose (blood sugar) CPT Code: `82947`	$25	$4	$4	1.0×
Blood test, lipase CPT Code: `83690`	$44	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$30	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$30	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$25	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$49	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$38	$6	$6	1.0×
Hepatitis C antibody test CPT Code: `86803`	$90	$15	$15	1.0×
Culture, blood CPT Code: `87040`	$66	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	$55	$9	$9	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$35	$25	$25	1.0×
Community mental health services HCPCS Code: `H0038`	—	$16	$16	1.0×
Diagnostic procedure preparation HCPCS Code: `G0279`	$18	$34	$35	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$74	$26	$27	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$122	$19	$20	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$95	$15	$16	0.9×
Speech therapy (group session) CPT Code: `92508`	$87	$25	$27	0.9×
Prosthetic fitting and training CPT Code: `97761`	$151	$39	$45	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$13	$14	0.9×
Physical therapy (gait training) CPT Code: `97116`	$115	$28	$33	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	—	$32	$38	0.8×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$9	$21	$25	0.8×
Colorectal cancer screening HCPCS Code: `G0010`	$113	$41	$49	0.8×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$151	$33	$40	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$130	$31	$38	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$123	$31	$38	0.8×
X-ray, hand CPT Code: `73130`	$340	$35	$93	0.4×
Blood test, basic metabolic panel CPT Code: `80048`	$53	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$67	$11	$11	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$85	$14	$14	1.0×
Blood test, liver function panel CPT Code: `80076`	$52	$9	$9	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$61	$10	$10	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$122	$19	$19	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$106	$17	$18	0.9×
X-ray, ankle CPT Code: `73610`	$425	$34	$93	0.4×
X-ray, shoulder CPT Code: `73030`	$425	$32	$92	0.3×
X-ray, foot CPT Code: `73630`	$425	$32	$92	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$20	$3	$3	1.0×
Blood test, calcium CPT Code: `82310`	$32	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$32	$5	$5	1.0×
Blood test, magnesium CPT Code: `83735`	$42	$7	$7	1.0×
Blood test, amylase CPT Code: `82150`	$41	$6	$7	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$27	$4	$5	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$105	$26	$34	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$115	$26	$35	0.7×
Flu vaccine injection HCPCS Code: `G0008`	$113	$33	$48	0.7×
Pneumonia vaccine injection HCPCS Code: `G0009`	$113	$33	$49	0.7×
Psychological testing evaluation CPT Code: `96136`	$15	$40	$128	0.3×
X-ray, chest (two views) CPT Code: `71046`	$425	$28	$93	0.3×
X-ray, chest (single view) CPT Code: `71045`	$340	$21	$92	0.2×
X-ray, pelvis CPT Code: `72170`	$411	$24	$110	0.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$464	$42	$201	0.2×
Psychological testing by technician CPT Code: `96138`	$21	$60	$395	0.2×
Blood test, hemoglobin CPT Code: `85018`	$15	$2	$3	0.7×
Behavioral health living support HCPCS Code: `H2019`	—	$12	$34	0.4×
Mental health services (therapy) HCPCS Code: `H0032`	—	$17	$65	0.3×
Group therapy session CPT Code: `90853`	$16	$26	$100	0.3×
Blood antibody screen CPT Code: `86850`	$338	$11	$46	0.2×
Mental health services (assessment) HCPCS Code: `H0031`	—	$29	$140	0.2×

Showing top 25 high-impact procedures of 134 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 11.3%

Audit a Bill or Quote at Forbes Hospital (Zero PHI Required)

CMS CCN: 390267

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $23,401

1. Amount on Your Bill or Quote ($) Pre-filled with Forbes Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $6,341 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $6,341

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (11.3% of gross = $6,341).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Forbes Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$25,387 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($56,162) is $25,387 above the denoised Fair BaseRate ($30,775) and 2.4× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (11.3% 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.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite59/100

Would Recommend69%

Rated 9 or 10 (HCAHPS)66%

Median ER Wait252 min

Left ER Before Seen3%

30-Day Mortality vs U.S.same

Unplanned Readmissionworse

Hip/Knee Complication Rate3.9%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Forbes Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-06-04·administrative_or_closure
Met Requirements
Recorded
2024-08-16·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (342 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Forbes Hospital.

Price Index: 0.80× regional baseline

Quality: 49/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

University of Pittsburgh Medical Center

+138.4%

Median Household Income$76,393U.S. Census ACS

Local Uninsured Share3.9%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 79/100 · Corroborated CMS CCN 390267

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 390267) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-14

Validated Rate Rows17,958 (CMS v3.0.0)

File Integrity DigestVerified · CCN 390267

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.

Submit MRF Update Correction Policy