Saint Clair Memorial Hospital · Pittsburgh, PA
34
In-network payers
262
Disclosed rate categories
329
Beds
4
Care quality
St. Clair Hospital is a 329-bed voluntary non-profit - private hospital in Pittsburgh, PA, affiliated with Saint Clair Memorial Hospital. Below you'll find publicly disclosed negotiated rates and facility details, including 34 in-network payers and 262 disclosed rate categories.
CCN (Medicare provider number)
390228
NPI
1073587119
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Private
Beds
329
Care Quality
4
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services St. Clair Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$7,202 - $9,562
from 4 insurers · median $8,238
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Medicine & Surgery · Inpatient
MS-DRG 470
$23,713 - $43,270
from 4 insurers · median $27,089
164 Medicare discharges for this DRG in CMS hospital data
Childbirth · Inpatient
MS-DRG 788
$10,685 - $13,504
from 4 insurers · median $12,122
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Gynecology
CPT 58558
$3,494 - $8,788
from 4 insurers · median $6,613
20 Medicare claims in Level 4 Gynecologic Procedures (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 460
$42,385 - $58,292
from 3 insurers · median $44,276
28 Medicare discharges for this DRG in CMS hospital data
Medicine & Surgery
CPT 66984
$2,505 - $6,712
from 4 insurers · median $4,640
689 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
Medicine & Surgery
CPT 47562
$6,076 - $16,199
from 4 insurers · median $11,538
86 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 74177
$409 - $1,145
from 4 insurers · median $643
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$10,597 - $28,244
from 4 insurers · median $20,380
28 Medicare claims in Level 2 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 49650
$5,957 - $16,199
from 4 insurers · median $13,174
86 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 216
$121,244 - $141,172
from 4 insurers · median $136,394
Hospital reports cardiac thoracic surgery services to CMS
Digestive procedures
CPT 45385
$1,274 - $3,366
from 4 insurers · median $2,304
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$7,202 - $9,562
from 4 insurers · median $8,238
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Digestive procedures
CPT 45380
$1,276 - $3,366
from 4 insurers · median $2,411
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$1,002 - $2,566
from 4 insurers · median $1,773
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$641 - $1,564
from 4 insurers · median $797
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$1,704 - $4,125
from 4 insurers · median $2,769
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78815
$2,129 - $4,629
from 4 insurers · median $3,035
Common here, based on CMS Medicare volume
Gynecology
CPT 58661
$6,060 - $16,199
from 4 insurers · median $11,717
Typical for a hospital with this service line
Mammography
CPT 77067
$90 - $167
from 4 insurers · median $135
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$102 - $270
from 4 insurers · median $135
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$123 - $332
from 4 insurers · median $194
Common here, based on CMS Medicare volume
Gynecology
CPT 58662
$6,072 - $16,199
from 4 insurers · median $11,881
Typical for a hospital with this service line
Urology
CPT 50590
$3,800 - $9,962
from 4 insurers · median $7,023
103 Medicare claims in Level 4 Urology and Related Services (CMS 2024)
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 24 | 276% | 0 | 15 |
| Insurer B* | 23 | 219% | 7 | 7 |
| Insurer C* | 24 | 175% | 10 | 8 |
| Insurer D* | 24 | 106% | 2 | 18 |
How we chose these services: 8 appear in this hospital's own Medicare claims, 10 are common here based on CMS Medicare volume, and 6 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for St. Clair Hospital.
1000 Bower Hill Road, Pittsburgh, PA 15243
(412) 942-4000
The nearest hospitals of similar type and size. Their rates are compared with St. Clair Hospital for the same insurers and services above.
Upmc Mercy
▲ Rates typically 6% higher than St. Clair Hospital (19 services)
Allegheny General Hospital
▲ Rates typically 13% higher than St. Clair Hospital (21 services)
Upmc Magee-Womens Hospital
▲ Rates typically 20% higher than St. Clair Hospital (19 services)
West Penn Hospital
▲ Rates typically 13% higher than St. Clair Hospital (21 services)
Jefferson Hospital
▼ Rates typically 11% lower than St. Clair Hospital (21 services)
Upmc Mckeesport
▲ Rates typically 29% higher than St. Clair Hospital (15 services)
Upmc Shadyside
About St. Clair Hospital's rates and hospital price transparency.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at St. Clair Hospital range from $409 to $1,145 across 4 insurers. Aetna's rate is $542. The median at nearby comparable hospitals is $2,119. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at St. Clair Hospital range from $1,274 to $3,366 across 4 insurers. Cigna's rate is $2,675. The median at nearby comparable hospitals is $2,002. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at St. Clair Hospital range from $7,202 to $9,562 across 4 insurers. UnitedHealthcare's rate is $8,268. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at St. Clair Hospital range from $90 to $167 across 4 insurers. UnitedHealthcare's rate is $103. The median at nearby comparable hospitals is $139. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at St. Clair Hospital range from $23,713 to $43,270 across 4 insurers. Aetna's rate is $27,356. The median at nearby comparable hospitals is $34,517. What a patient pays depends on their plan's deductible, coinsurance and network status.
St. Clair Hospital has 329 beds. Facility type: Short Term Acute Care Hospital.
St. Clair Hospital is located at 1000 Bower Hill Road, Pittsburgh, PA 15243. Its main phone number is (412) 942-4000.
St. Clair Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 390228.
The National Provider Identifier (NPI) on file for St. Clair Hospital is 1073587119.
St. Clair Hospital is affiliated with Saint Clair Memorial Hospital.
St. Clair Hospital lists 34 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
262 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers