Occupational Therapy Evaluation (high complexity) at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$413.40
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$689.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$50.52 with Highmark BCBS of PA vs $585.65 with Humana — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $50.52 | ↓ -88% |
| Aetna | Medicare | $76.97 | ↓ -81% |
| Highmark BCBS of PA | Managed Care - Social Mission | $87.72 | ↓ -79% |
| UPMC Work Partners | Workers Comp | $101.56 | ↓ -75% |
| Highmark BCBS of PA | Managed Care | $117.48 | ↓ -72% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $190.45 | ↓ -54% |
| UPMC Health Plan | CHIP | $207.54 | ↓ -50% |
| Aetna | Neighborhood Network | $239.08 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Indemnity | $255.06 | ↓ -38% |
| Aetna | Home Depot Employer Group | $259.75 | ↓ -37% |
| Aetna | EBR FI | $261.82 | ↓ -37% |
| Aetna | NBR ASO/FI | $265.26 | ↓ -36% |
| Cigna | New Business ASO | $265.26 | ↓ -36% |
| Aetna | EBR ASO | $275.60 | ↓ -33% |
| Cigna | Commercial | $275.60 | ↓ -33% |
| InterGroup | PPO | $344.50 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $344.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $378.95 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $413.40 | ↑ +0% |
| UPMC Health Plan | Commercial | $427.45 | ↑ +3% |
| Coventry/First Health | Commercial | $482.30 | ↑ +17% |
| Private Health Care Systems | PPO | $551.20 | ↑ +33% |
| SelectCare | Commercial | $551.20 | ↑ +33% |
| Humana | Commercial | $585.65 | ↑ +42% |
Visitor-reported prices
Comments
Occupational Therapy Evaluation (high complexity) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $226.80 | $50.04 – $302.40 |
| UPMC Bedford | Everett | $299.40 | $101.56 – $449.10 |
| UPMC Carlisle | Carlisle | $363.00 | $80.87 – $514.25 |
| UPMC Cole | Coudersport | $281.40 | $84.11 – $375.20 |
| UPMC Community Osteopathic | Harrisburg | $363.00 | $80.87 – $514.25 |
| UPMC East | Monroeville | $411.60 | $50.52 – $548.80 |
| UPMC Hamot | Erie | $307.80 | $50.04 – $177.27 |
| UPMC Northwest | Seneca | $272.40 | $101.56 – $251.14 |