Occupational Therapy Evaluation (moderate complexity) at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$373.20
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.
$622.00
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 $572.24 with Multiplan — 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 | ↓ -86% |
| Aetna | Medicare | $76.97 | ↓ -79% |
| UPMC Work Partners | Workers Comp | $101.56 | ↓ -73% |
| Aetna | CHIP/Medicaid | $111.96 | ↓ -70% |
| Highmark BCBS of PA | Managed Care - Social Mission | $126.05 | ↓ -66% |
| Highmark BCBS of PA | Managed Care | $168.82 | ↓ -55% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $169.45 | ↓ -55% |
| Aetna | Neighborhood Network | $223.92 | ↓ -40% |
| Highmark BCBS of PA | Commercial - Indemnity | $226.92 | ↓ -39% |
| UPMC Health Plan | CHIP | $231.34 | ↓ -38% |
| Aetna | EBR FI | $242.58 | ↓ -35% |
| Aetna | Home Depot Employer Group | $243.82 | ↓ -35% |
| Aetna | NBR ASO/FI | $248.80 | ↓ -33% |
| Cigna | Commercial | $248.80 | ↓ -33% |
| Cigna | New Business ASO | $248.80 | ↓ -33% |
| Aetna | EBR ASO | $248.80 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $253.22 | ↓ -32% |
| InterGroup | PPO | $311.00 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $311.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $342.10 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $342.10 | ↓ -8% |
| UPMC Health Plan | Commercial | $357.38 | ↓ -4% |
| Coventry/First Health | Commercial | $435.40 | ↑ +17% |
| Preferred Healthcare System | PPO | $497.60 | ↑ +33% |
| Humana | Commercial | $528.70 | ↑ +42% |
| Private Health Care Systems | PPO | $528.70 | ↑ +42% |
| Multiplan | PPO | $572.24 | ↑ +53% |
Visitor-reported prices
Comments
Occupational Therapy Evaluation (moderate complexity) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $338.40 | $50.04 – $182.67 |
| UPMC Passavant-McCandless | Pittsburgh | $411.00 | $50.52 – $335.70 |
| UPMC Presbyterian | Pittsburgh | $748.80 | $30.40 – $374.03 |
| UPMC St. Margaret | Pittsburgh | $319.20 | $50.52 – $283.87 |
| UPMC Altoona | Altoona | $226.80 | $50.04 – $302.40 |
| UPMC Bedford | Everett | $299.40 | $101.56 – $449.10 |
| UPMC Carlisle | Carlisle | $303.60 | $33.18 – $430.10 |
| UPMC Cole | Coudersport | $281.40 | $84.11 – $375.20 |