Evaluation psychiatric diagnostic at UPMC Western Psychiatric
3811 Ohara St, Pittsburgh, PA · UPMC · · NPI 1174962435
$993.00
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.
$1,655.00
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.
$25.00 with Aetna vs $285.01 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Aetna | Medicare | $25.00 | ↓ -97% |
| Aetna | Narrow Network | $29.70 | ↓ -97% |
| Aetna | Fully Insured | $33.00 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicare | $50.00 | ↓ -95% |
| Cigna Behavioral Health | Commercial | $60.00 | ↓ -94% |
| Aetna | Commercial | $60.00 | ↓ -94% |
| Fidelis | Medicare | $75.00 | ↓ -92% |
| Health Payors Organization | Commercial | $85.00 | ↓ -91% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $285.01 | ↓ -71% |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Evaluation psychiatric diagnostic at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $159.60 | $143.36 – $290.86 |
| UPMC Presbyterian | Pittsburgh | $265.80 | $31.50 – $290.86 |
| UPMC Carlisle | Carlisle | $358.20 | $34.39 – $507.45 |
| UPMC Community Osteopathic | Harrisburg | $669.00 | $34.39 – $507.45 |
| UPMC Hanover | Hanover | $358.20 | $34.39 – $245.58 |
| UPMC Jameson | New Castle | $254.40 | $30.19 – $293.20 |
| UPMC Lititz | Lititz | $358.20 | $34.39 – $246.91 |
| UPMC Memorial | York | $358.20 | $34.39 – $246.51 |