▸ Hospital · PA · CCN 390102
UPMC St. Margaret
815 FREEPORT ROAD, PITTSBURGH, PA, 15215
170 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
153
of 209 target codes
Payers
13
with negotiated rates
Rates published
42,437
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 4 | — | — | $9,241.2 | $12,379 | $24,757 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 10 | $398 | $238.8 | $51.6 | $151.24 | $427.09 |
| ED visit level 2 | CPT | 99282 | 12 | $561 | $336.6 | $36.28 | $177.43 | $646.64 |
| ED visit level 3 | CPT | 99283 | 12 | $848 | $508.8 | $62.31 | $287.74 | $869.82 |
| ED visit level 4 | CPT | 99284 | 12 | $1,897 | $1,138.2 | $104.86 | $534.96 | $1,612.45 |
| ED visit level 5 | CPT | 99285 | 12 | $5,198 | $3,118.8 | $152.61 | $1,390.47 | $4,418.3 |
| Critical care, first hour | CPT | 99291 | 12 | $4,295 | $2,577 | $166.79 | $1,189.72 | $3,650.75 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 12 | $2,900 | $1,740 | $87.53 | $812 | $2,465 |
| CT head with contrast | CPT | 70460 | 12 | $4,538 | $2,722.8 | $146.54 | $1,257.03 | $3,857.3 |
| CT head with and without contrast | CPT | 70470 | 12 | $5,049 | $3,029.4 | $146.54 | $1,413.72 | $4,291.65 |
| CT neck with contrast | CPT | 70491 | 12 | $4,538 | $2,722.8 | $146.54 | $1,270.64 | $3,857.3 |
| MRI brain without contrast | CPT | 70551 | 13 | $6,138 | $3,682.8 | $198.97 | $1,718.64 | $5,217.3 |
| MRI brain with contrast | CPT | 70552 | 13 | $7,904 | $4,742.4 | $293.97 | $2,213.12 | $6,718.4 |
| MRI brain with and without contrast | CPT | 70553 | 13 | $9,684 | $5,810.4 | $293.97 | $2,750.26 | $8,231.4 |
| Chest X-ray single view | CPT | 71045 | 12 | $675 | $405 | $6.49 | $180.57 | $573.75 |
| Chest X-ray 2 views | CPT | 71046 | 12 | $675 | $405 | $11.9 | $180.57 | $573.75 |
| Chest X-ray 3 views | CPT | 71047 | 12 | $675 | $405 | $15.12 | $180.57 | $573.75 |
| CT chest without contrast | CPT | 71250 | 12 | $2,900 | $1,740 | $87.53 | $832.3 | $2,465 |
| CT chest with contrast | CPT | 71260 | 12 | $4,538 | $2,722.8 | $146.54 | $1,270.64 | $3,857.3 |
| CT chest with and without contrast | CPT | 71270 | 12 | $5,049 | $3,029.4 | $146.54 | $1,413.72 | $4,291.65 |
| MRI chest without contrast | CPT | 71550 | 13 | $6,138 | $3,682.8 | $198.97 | $1,718.64 | $5,217.3 |
| MRI chest with contrast | CPT | 71551 | 13 | $5,441 | $3,264.6 | $431.72 | $1,577.89 | $4,624.85 |
| MRI chest with and without contrast | CPT | 71552 | 13 | $9,684 | $5,810.4 | $293.97 | $2,750.26 | $8,231.4 |
| Lumbosacral spine X-ray | CPT | 72100 | 12 | $675 | $405 | $34.37 | $186.98 | $573.75 |
| CT cervical spine without contrast | CPT | 72125 | 12 | $2,900 | $1,740 | $87.53 | $832.3 | $2,465 |
| CT thoracic spine without contrast | CPT | 72128 | 12 | $2,900 | $1,740 | $87.53 | $832.3 | $2,465 |
| CT lumbar spine without contrast | CPT | 72131 | 12 | $2,900 | $1,740 | $87.53 | $832.3 | $2,465 |
| MRI cervical spine without contrast | CPT | 72141 | 13 | $6,138 | $3,682.8 | $198.97 | $1,718.64 | $5,217.3 |
| MRI thoracic spine without contrast | CPT | 72146 | 13 | $6,138 | $3,682.8 | $198.97 | $1,743.19 | $5,217.3 |
| MRI lumbar spine without contrast | CPT | 72148 | 13 | $6,138 | $3,682.8 | $198.97 | $1,743.19 | $5,217.3 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 13 | $7,904 | $4,742.4 | $293.97 | $2,213.12 | $6,718.4 |
| MRI cervical spine with and without contrast | CPT | 72156 | 13 | $9,684 | $5,810.4 | $293.97 | $2,750.26 | $8,231.4 |
| MRI lumbar spine with contrast | CPT | 72158 | 13 | $9,684 | $5,810.4 | $293.97 | $2,750.26 | $8,231.4 |
| CT pelvis without contrast | CPT | 72192 | 12 | $2,900 | $1,740 | $87.53 | $832.3 | $2,465 |
| CT pelvis with contrast | CPT | 72193 | 12 | $4,538 | $2,722.8 | $146.54 | $1,270.64 | $3,857.3 |
| Shoulder X-ray | CPT | 73030 | 10 | $675 | $405 | $28.65 | $193.73 | $573.75 |
| Humerus X-ray | CPT | 73060 | 10 | $675 | $405 | $28.07 | $193.73 | $573.75 |
| Hand X-ray 3 views | CPT | 73130 | 10 | $675 | $405 | $26.83 | $193.73 | $573.75 |
| MRI upper extremity joint without contrast | CPT | 73221 | 11 | $6,138 | $3,682.8 | $198.97 | $1,780.02 | $5,217.3 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 11 | $9,684 | $5,810.4 | $293.97 | $2,918.67 | $8,231.4 |
| Knee X-ray 1-2 views | CPT | 73560 | 10 | $675 | $405 | $30.24 | $193.61 | $573.75 |
| Ankle X-ray 3 views | CPT | 73610 | 10 | $675 | $405 | $26.31 | $193.73 | $573.75 |
| MRI lower extremity joint without contrast | CPT | 73721 | 11 | $6,138 | $3,682.8 | $198.97 | $1,780.02 | $5,217.3 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 11 | $9,684 | $5,810.4 | $293.97 | $2,918.67 | $8,231.4 |
| CT abdomen without contrast | CPT | 74150 | 12 | $2,900 | $1,740 | $87.53 | $832.3 | $2,465 |
| CT abdomen with contrast | CPT | 74160 | 12 | $4,538 | $2,722.8 | $146.54 | $1,270.64 | $3,857.3 |
| CT abdomen with and without contrast | CPT | 74170 | 12 | $5,049 | $3,029.4 | $146.54 | $1,413.72 | $4,291.65 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 12 | $6,126 | $3,675.6 | $185.12 | $1,715.28 | $5,207.1 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 12 | $8,773 | $5,263.8 | $289.48 | $2,430.12 | $7,457.05 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 12 | $8,773 | $5,263.8 | $293.97 | $2,456.44 | $7,457.05 |
| MRI abdomen without contrast | CPT | 74181 | 13 | $6,138 | $3,682.8 | $198.97 | $1,718.64 | $5,217.3 |
| MRI abdomen with and without contrast | CPT | 74183 | 13 | $9,684 | $5,810.4 | $293.97 | $2,750.26 | $8,231.4 |
| Abdominal ultrasound complete | CPT | 76700 | 12 | $3,856 | $2,313.6 | $87.53 | $1,031.48 | $3,277.6 |
| Abdominal ultrasound limited | CPT | 76705 | 12 | $1,784 | $1,070.4 | $68.75 | $494.17 | $1,516.4 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 12 | $1,435 | $861 | $87.53 | $401.8 | $1,219.75 |
| Obstetric ultrasound first trimester | CPT | 76801 | 12 | $735 | $441 | $87.53 | $213.15 | $853.43 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 12 | $2,948 | $1,768.8 | $85.25 | $816.6 | $2,505.8 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 12 | $2,715 | $1,629 | $189.08 | $779.21 | $2,307.75 |
| Transvaginal ultrasound | CPT | 76830 | 12 | $2,781 | $1,668.6 | $84.15 | $743.92 | $2,363.85 |
| Pelvic ultrasound complete | CPT | 76856 | 12 | $2,785 | $1,671 | $84.15 | $744.99 | $2,367.25 |
| Scrotal ultrasound | CPT | 76870 | 12 | $1,784 | $1,070.4 | $81.4 | $494.17 | $1,516.4 |
| Diagnostic mammography unilateral | CPT | 77065 | 11 | $703 | $421.8 | $58.27 | $203.87 | $597.55 |
| Diagnostic mammography bilateral | CPT | 77066 | 11 | $853 | $511.8 | $74.31 | $267.71 | $725.05 |
| Screening mammography bilateral | CPT | 77067 | 11 | $342 | $205.2 | $61.53 | $136.9 | $366.95 |
| EKG tracing only | CPT | 93005 | 12 | $334 | $200.4 | $11.51 | $92.52 | $283.9 |
| Transthoracic echocardiogram complete | CPT | 93306 | 12 | $3,225 | $1,935 | $155.12 | $935.25 | $2,741.25 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 4 | — | — | $16,493 | $20,714 | $64,728 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 4 | — | — | $8,423.35 | $10,407 | $40,663 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 4 | — | — | $5,795.44 | $7,049.66 | $31,765 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 4 | — | — | $12,878 | $16,097 | $49,883 |
| COPD w MCC | MS-DRG | 190 | 4 | — | — | $9,208.75 | $11,410 | $33,655 |
| COPD w CC | MS-DRG | 191 | 4 | — | — | $7,074.32 | $8,683.32 | $29,736 |
| COPD w/o CC/MCC | MS-DRG | 192 | 4 | — | — | $5,453.57 | $6,612.92 | $23,743 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 4 | — | — | $6,775.18 | $8,301.17 | $28,169 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 4 | — | — | $5,344.7 | $6,473.86 | $21,161 |
| AMI discharged alive w MCC | MS-DRG | 280 | 4 | — | — | $13,211 | $16,523 | $50,529 |
| AMI discharged alive w CC | MS-DRG | 281 | 4 | — | — | $7,687.96 | $9,467.19 | $34,854 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 4 | — | — | $6,107.53 | $7,448.29 | $31,442 |
| Heart failure & shock w MCC | MS-DRG | 291 | 4 | — | — | $10,629 | $13,224 | $39,049 |
| Heart failure & shock w CC | MS-DRG | 292 | 4 | — | — | $7,122.71 | $8,745.12 | $26,647 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 4 | — | — | $4,840.73 | $5,830.08 | $23,835 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 4 | — | — | $9,985.26 | $12,402 | $36,237 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 4 | — | — | $6,209.12 | $7,578.08 | $22,821 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 4 | — | — | $4,841.54 | $5,831.11 | $17,842 |
| GI hemorrhage w CC | MS-DRG | 378 | 4 | — | — | $8,184.68 | $10,102 | $35,499 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 4 | — | — | $5,360.04 | $6,493.44 | $25,034 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 4 | — | — | $6,563.1 | $8,030.27 | $23,927 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 4 | — | — | $12,918 | $16,148 | $70,445 |
| Kidney/UTI w MCC | MS-DRG | 689 | 4 | — | — | $9,632.89 | $11,952 | $42,046 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 4 | — | — | $6,804.22 | $8,338.25 | $23,005 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 4 | — | — | $15,940 | $20,009 | $64,636 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 4 | — | — | $8,528.19 | $10,541 | $33,010 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 12 | $162 | $97.2 | $7.3 | $46.5 | $137.7 |
| Electrolyte panel | CPT | 80051 | 12 | $147 | $88.2 | $6.05 | $42.04 | $124.95 |
| Comprehensive metabolic panel | CPT | 80053 | 12 | $167 | $100.2 | $9.12 | $48.43 | $141.95 |
| Lipid panel | CPT | 80061 | 12 | $458 | $274.8 | $11.56 | $126.75 | $389.3 |
| Renal function panel | CPT | 80069 | 12 | $192 | $115.2 | $7.49 | $54.35 | $163.2 |
| Hepatic function panel | CPT | 80076 | 12 | $359 | $215.4 | $7.05 | $99.45 | $305.15 |
| Urinalysis non-automated | CPT | 81002 | 12 | $118 | $70.8 | $3 | $32.51 | $100.3 |
| Urinalysis automated | CPT | 81003 | 12 | $68 | $40.8 | $1.94 | $19.04 | $57.8 |
| Glucose quantitative | CPT | 82947 | 12 | $114 | $68.4 | $3.39 | $31.58 | $96.9 |
| Hemoglobin A1c | CPT | 83036 | 12 | $162 | $97.2 | $7.7 | $46.5 | $137.7 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 12 | $340 | $204 | $14.51 | $95.2 | $289 |
| Complete blood count with automated differential | CPT | 85025 | 12 | $155 | $93 | $6.6 | $43.64 | $131.75 |
| Complete blood count without differential | CPT | 85027 | 12 | $94 | $56.4 | $5.59 | $26.98 | $79.9 |
| Urine culture bacterial | CPT | 87086 | 12 | $289 | $173.4 | $6.97 | $77.31 | $245.65 |
| Urine culture identification | CPT | 87088 | 12 | $117 | $70.2 | $6.98 | $33.58 | $99.45 |
| Tissue exam by pathologist level IV | CPT | 88305 | 12 | $1,262 | $757.2 | $27.86 | $337.59 | $1,072.7 |
| maternity | ||||||||
| Vaginal delivery only | CPT | 59409 | 10 | $10,937 | $6,562.2 | $642.43 | $4,156.06 | $9,296.45 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 12 | $237 | $142.2 | $36.08 | $90.06 | $365.15 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 12 | $370 | $222 | $36.08 | $140.6 | $470.51 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 12 | $648 | $388.8 | $36.08 | $219.29 | $585.14 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 12 | $780 | $468 | $36.08 | $260.91 | $695.27 |
| Office visit, established patient, 5 min | CPT | 99211 | 12 | $204 | $122.4 | $22 | $63.91 | $173.4 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 12 | $273 | $163.8 | $28.6 | $80.57 | $232.05 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 12 | $306 | $183.6 | $36.08 | $103.8 | $278.02 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 12 | $381 | $228.6 | $36.08 | $125.62 | $334.76 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 12 | $452 | $271.2 | $36.08 | $145.99 | $389.03 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 12 | $4,188 | $2,512.8 | $137.74 | $1,214.52 | $3,559.8 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 12 | $6,930 | $4,158 | $163.44 | $1,988.91 | $5,890.5 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 12 | $997 | $598.2 | $58.47 | $398.8 | $2,014.38 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 12 | $3,108 | $1,864.8 | $70.04 | $947.44 | $3,281.43 |
| Colonoscopy diagnostic | CPT | 45378 | 12 | $2,500 | $1,500 | $198.55 | $950 | $4,393.81 |
| Colonoscopy with biopsy | CPT | 45380 | 12 | $8,113 | $4,867.8 | $247.96 | $2,271.64 | $6,896.05 |
| Colonoscopy with polyp removal | CPT | 45385 | 12 | $7,394 | $4,436.4 | $294.89 | $2,116.15 | $6,284.9 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 5 | — | — | $2,642.84 | $10,244 | $19,286 |
| Total hip replacement | CPT | 27130 | 5 | — | — | $2,492.82 | $10,591 | $19,869 |
| Total knee replacement | CPT | 27447 | 5 | — | — | $2,690.84 | $10,591 | $19,869 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 3 | — | — | $844.93 | $2,453.84 | $5,038.97 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 5 | — | — | $1,274.16 | $4,939.05 | $7,598.8 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 7 | — | — | $597.85 | $2,494.05 | $6,206.98 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 4 | — | — | $37,341 | $47,346 | $132,776 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 4 | — | — | $19,607 | $24,692 | $81,648 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 4 | — | — | $13,847 | $17,335 | $61,363 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 4 | — | — | $13,917 | $17,424 | $58,827 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 4 | — | — | $11,290 | $14,068 | $48,915 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 4 | — | — | $27,750 | $35,095 | $154,076 |
| Laparoscopic appendectomy | CPT | 44970 | 5 | — | — | $1,067.82 | $4,911.06 | $9,822.12 |
| Major joint replacement w MCC | MS-DRG | 469 | 4 | — | — | $24,735 | $31,243 | $102,395 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 4 | — | — | $15,831 | $19,869 | $55,600 |
| Laparoscopic cholecystectomy | CPT | 47562 | 5 | — | — | $1,414.39 | $4,911.06 | $9,822.12 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 5 | — | — | $1,521.52 | $4,911.06 | $9,822.12 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 4 | — | — | $23,760 | $29,998 | $117,516 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 4 | — | — | $17,166 | $21,574 | $82,432 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 4 | — | — | $13,428 | $16,800 | $59,703 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 4 | — | — | $23,559 | $29,742 | $100,873 |
| OR procedure for obesity w CC | MS-DRG | 620 | 4 | — | — | $13,181 | $16,484 | $58,873 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 4 | — | — | $12,440 | $15,537 | $47,532 |
| Complex cataract surgery | CPT | 66982 | 5 | — | — | $1,339.89 | $2,348.35 | $8,695.52 |
| Cataract surgery with lens implant | CPT | 66984 | 7 | — | — | $662.78 | $2,331.1 | $8,695.52 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 4 | — | — | $10,281 | $12,780 | $40,248 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 4 | — | — | $16,800 | $18,144 | $46,979 |
| Coronary angiography with bypass cath | CPT | 93458 | 10 | $28,643 | $17,186 | $1,321.51 | $8,220.54 | $24,347 |
Payer mix (top 13)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 153 | $1,005.83 |
| upmc health plan | 153 | $293.97 |
| Aetna | 152 | $725 |
| pa health & wellness | 152 | $248.89 |
| upmc work partners | 107 | $440.12 |
| Humana | 99 | $2,363.85 |
| Cigna | 99 | $812 |
| private health care systems | 99 | $2,224.8 |
| selectcare | 99 | $2,224.8 |
| First Health | 99 | $1,946.7 |
| UnitedHealthcare | 89 | $123.75 |
| amerihealth caritas | 89 | $175.62 |
| premier comp solutions | 18 | $1,321.86 |