CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: UPMC Northwest

Billing Code: 97530 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$40
about 1.1× the $35 Medicare rate · typically $19–$55
modeled estimate · not a bill or quote
What this hospital charges insurers
$22
Below the fair price — a good deal
about $18 under the fair price · 0.6× Medicare
Medicare pays $35 Fair price $40 This hospital $22 Cash price $64 Hospital's list price $106

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $13 Priciest $22

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Occupational therapy (therapeutic activities) is about $40 (about 1.1× the $35 Medicare rate). UPMC Northwest charges insurers about $22, or about $64 in cash — below the fair price — a good deal. Located in Seneca, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $15 43%
Blue Cross Blue Shieldmajor $19 - $65 54%
Aetnamajor $16 - $69 46%
Cignamajor $42 - $69 120%
Humanamajor $90 257%
AmeriHealth $20 57%
UPMC Health Plan $14 - $87 40%
+ 4 smaller / regional plans $22 - $3,704
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 100 Fairfield Drive, Seneca, PA 16346
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals