Physical Therapy Re-Evaluation at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$96.00
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.
$160.00
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.
$35.56 with Highmark BCBS of PA vs $172.00 with United Healthcare — 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 | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $35.56 | ↓ -63% |
| UPMC Work Partners | Workers Comp | $43.98 | ↓ -54% |
| UPMC Health Plan | Managed Medicaid | $47.43 | ↓ -51% |
| Aetna of PA | Medicare | $47.77 | ↓ -50% |
| Aetna | Medicaid | $48.73 | ↓ -49% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $49.59 | ↓ -48% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $56.06 | ↓ -42% |
| Geisinger | Medicaid/CHIP | $59.93 | ↓ -38% |
| PA Health & Wellness | PA Medicaid HMO | $73.49 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $80.00 | ↓ -17% |
| UPMC Health Plan | CHIP | $84.70 | ↓ -12% |
| Occunet | Commercial | $85.00 | ↓ -11% |
| UPMC Health Plan | Commercial | $95.89 | ↓ -0% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $120.00 | ↑ +25% |
| Humana | Commercial | $128.00 | ↑ +33% |
| National Provider Network | PPO | $140.80 | ↑ +47% |
| Cigna | Commercial | $145.55 | ↑ +52% |
| United Healthcare | Commercial | $172.00 | ↑ +79% |
Visitor-reported prices
Comments
Physical Therapy Re-Evaluation at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $113.40 | $34.95 – $151.20 |
| UPMC Bedford | Everett | $125.40 | $45.28 – $188.10 |
| UPMC Carlisle | Carlisle | $139.20 | $31.78 – $387.00 |
| UPMC Cole | Coudersport | $125.40 | $43.98 – $167.20 |
| UPMC Community Osteopathic | Harrisburg | $139.20 | $46.40 – $197.20 |
| UPMC East | Monroeville | $155.40 | $35.28 – $207.20 |
| UPMC Hamot | Erie | $121.20 | $34.95 – $121.18 |
| UPMC Northwest | Seneca | $105.00 | $47.43 – $90.70 |