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Evaluation for Occupational Therapy, Typically 1 Hour Cost in Pennsylvania
What this costs without insurance: real self-pay cash prices and insurance-negotiated rates at 78 Pennsylvania hospitals. CPT 97167. Sourced directly from each facility's CMS-mandated transparency file. Dataset: Q4 2026.
📊 Median $258
📉 Low $69.20
📈 High $1,193
🏥 78 hospitals
🏛️ 59 with insurance contracts
🇺🇸 Medicare $100
Hospital comparison — Pennsylvania
Sorted by cash price (lowest first). Showing top 60 of 78 hospitals.
Billed more than $258 for this? That gap is evidence.
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| Hospital | Cash | Aetna | UHC | Cigna | Medicare | Humana | BCBS | Medicaid | Molina |
|---|---|---|---|---|---|---|---|---|---|
| CONEMAUGH NASON MEDICAL CENTER ROARING SPRING |
$69.20 | $69.97 | $100 | $41.20 | $100 | $100 | $100 | — | — |
| HERITAGE VALLEY SEWICKLEY MCKEES ROCKS |
$85.05 | $61.73 | $80.25 | $96.52 | — | — | — | — | — |
| HERITAGE VALLEY BEAVER BEAVER |
$85.05 | $61.73 | $86.42 | $96.52 | — | — | — | — | — |
| WARREN GENERAL HOSPITAL CRESCENT PARK WEST WARREN |
$96.00 | $63.00 | $74.08 | $60.00 | — | $101 | $100 | — | — |
| SUBURBAN COMMUNITY HOSPITAL NORRISTOWN |
$103 | — | $69.75 | $180 | $104 | $82.84 | $104 | — | — |
| LOWER BUCKS HOSPITAL BRISTOL |
$103 | — | $69.75 | $180 | $104 | $82.84 | $104 | — | — |
| PENNSYLVANIA PSYCHIATRIC INSTITUTE HARRISBURG |
$107 | — | — | — | — | — | — | — | — |
| JEFFERSON BUCKS HOSPITAL LANGHORNE |
$119 | $106 | — | — | — | — | — | $83.51 | — |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL PHILADELPHIA |
$119 | $117 | — | — | — | — | — | $83.51 | — |
| JEFFERSON LANSDALE HOSPITAL LANSDALE |
$119 | $106 | — | — | — | — | — | $83.51 | — |
| JEFFERSON FRANKFORD HOSPITAL PHILADELPHIA |
$119 | $106 | — | — | — | — | — | $83.51 | — |
| JEFFERSON TORRESDALE HOSPITAL PHILADELPHIA |
$119 | $106 | — | — | — | — | — | $83.51 | — |
| MAGEE REHABILITATION HOSPITAL PHILADELPHIA |
$119 | $81.54 | — | — | — | — | — | $110 | — |
| JEFFERSON ABINGTON HOSPITAL ABINGTON |
$119 | $92.18 | $73.50 | — | $147 | — | — | $61.73 | — |
| JEFFERSON METHODIST HOSPITAL PHILADELPHIA |
$119 | $117 | — | — | — | — | — | $83.51 | — |
| JEFFERSON MOSS-MAGEE REHABILITATION HOSPITAL - ELKINS PARK ELKINS PARK |
$123 | $90.20 | $91.93 | $111 | — | $107 | — | — | — |
| INDIANA REGIONAL MEDICAL CENTER INDIANA |
$123 | — | — | — | — | — | — | — | — |
| HOLY REDEEMER HOSPITAL MEADOWBROOK |
$125 | $111 | $91.00 | $111 | — | — | $72.72 | — | — |
| GOOD SHEPHERD REHABILITATION HOSPITAL CENTER VALLEY PARKWAY CENTER VALLEY |
$130 | $50.75 | $433 | $96.29 | $96.29 | $90.51 | $158 | — | — |
| PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER CAMP HILL |
$150 | — | — | — | — | — | — | — | — |
| CONEMAUGH MINERS MEDICAL CENTER HAIDA AVENUE HASTINGS |
$155 | $20.80 | $20.00 | $61.60 | — | — | $5.33 | — | — |
| ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL BENSALEM |
$159 | — | — | — | — | — | — | — | — |
| CONEMAUGH MEYERSDALE MEDICAL CENTER HOSPITAL DRIVE MEYERSDALE |
$161 | $39.52 | $38.00 | $61.60 | — | — | $581 | — | — |
| PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER BERNVILLE ROAD READING |
$163 | — | — | — | — | — | — | — | — |
| FULTON COUNTY MEDICAL CENTER PEACH ORCHARD RD. MC CONNELLSBURG |
$169 | $46.00 | $90.00 | $90.00 | $100 | $97.55 | $40.00 | — | — |
| PENN STATE HEALTH LANCASTER MEDICAL CENTER STATE ROAD LANCASTER |
$181 | — | — | — | — | — | — | — | — |
| MOUNT NITTANY MEDICAL CENTER STATE COLLEGE |
$188 | $96.89 | $98.83 | $96.89 | — | $98.83 | $101 | — | — |
| PENN STATE HEALTH HAMPDEN MEDICAL CENTER ENOLA |
$197 | — | — | — | — | — | — | — | — |
| LATROBE HOSPITAL LATROBE |
$210 | — | — | — | — | — | — | — | — |
| FRICK HOSPITAL MT PLESANT |
$210 | — | — | — | — | — | — | — | — |
| WESTMORELAND HOSPITAL GREEENSBURG |
$210 | — | — | — | — | — | — | — | — |
| NAZARETH HOSPITAL PHILADELPHIA |
$220 | — | — | — | — | — | — | — | — |
| MERCY FITZGERALD HOSPITAL DARBY |
$220 | — | — | — | — | — | — | — | — |
| PENN MEDICINE GOOD SHEPHERD REHABILITATION SPECIALTY HOSPITAL LOMBARD STREET FIFTH FLOOR PHILADELPHIA |
$229 | $388 | $49.00 | $105 | $105 | $98.37 | $112 | — | — |
| CONEMAUGH MEMORIAL HOSPITAL JOHNSTOWN |
$232 | $55.40 | $59.80 | $60.00 | — | — | $52.04 | — | — |
| UPMC WELLSBORO WELLSBORO |
$238 | — | — | — | — | — | — | — | — |
| BUCKTAIL MEDICAL CENTER RENOVO |
$246 | $198 | — | $80.00 | $94.59 | $231 | $343 | — | — |
| GUTHRIE ROBERT PACKER HOSPITAL SAYRE |
$258 | — | — | — | — | — | — | — | — |
| CLARION HOSPITAL CLARION |
$263 | $99.80 | $96.89 | $96.89 | $96.89 | — | — | — | — |
| GUTHRIE TROY COMMUNITY HOSPITAL TROY |
$272 | — | — | — | — | — | — | — | — |
| BARNES-KASSON COUNTY HOSPITAL SUSQUEHANNA |
$273 | $40.00 | $42.91 | $53.53 | $40.00 | $30.86 | — | $8.82 | — |
| CHILDRENS HOME OF PITTSBURGH & LEMIEUX FAMILY CENTER PITTSBURGH |
$285 | — | — | — | — | — | — | — | — |
| WELLSPAN GETTYSBURG HOSPITAL GETTYSBURG |
$313 | $98.59 | — | — | $95.95 | — | — | $54.00 | — |
| WELLSPAN YORK HOSPITAL YORK |
$313 | $99.80 | $102 | $349 | $96.89 | — | — | $56.80 | — |
| WELLSPAN YORK HOSPITAL YORK |
$313 | $99.80 | $102 | $349 | $96.89 | — | — | $56.80 | — |
| WELLSPAN SURGERY AND REHABILITATION HOSPITAL YORK |
$313 | $99.80 | $102 | $350 | $96.89 | — | — | $77.16 | — |
| WELLSPAN GOOD SAMARITAN HOSPITAL LEBANON |
$319 | $99.80 | $102 | $255 | $96.89 | — | — | $77.16 | — |
| WELLSPAN EVANGELICAL COMMUNITY HOSPITAL LEWISBURG |
$322 | $98.83 | $107 | — | $96.89 | $98.83 | — | $47.20 | — |
| BUTLER MEMORIAL HOSPITAL BUTLER |
$329 | $99.80 | $96.89 | $50.00 | $96.89 | $101 | — | — | — |
| UNIONTOWN HOSPITAL UNIONTOWN |
$345 | $60.00 | $86.20 | $90.00 | $96.52 | $101 | $177 | — | — |
| PENN HIGHLANDS MON VALLEY HOSPITAL COUNTRY CLUB RD. MONONGAHELA |
$349 | $26.90 | $99.80 | — | $96.89 | $99.80 | $91.08 | — | — |
| PENN HIGHLANDS CONNELLSVILLE E MURPHY AVE. CONNELLSVILLE |
$349 | $78.00 | $99.80 | — | $96.89 | — | $92.05 | — | — |
| ALLIED SERVICES SCRANTON REHAB HOSPITAL SCRANTON |
$357 | $97.00 | — | — | — | $97.00 | — | — | — |
| ALLIED SERVICES WILKES-BARRE REHAB HOSPITAL WILKES-BARRE TOWNSHIP |
$357 | $97.00 | — | — | — | $97.00 | — | — | — |
| ST MARY MEDICAL CENTER LANGHORNE |
$376 | — | — | — | — | — | — | — | — |
| PAM HEALTH SPECIALTY HOSPITAL HERITAGE VALLEY BEAVER |
$384 | — | — | — | — | — | — | — | $96.00 |
| PAM HEALTH SPECIALTY HOSPITAL HERITAGE VALLEY BEAVER |
$384 | — | — | — | — | — | — | — | $96.00 |
| PAM HEALTH SPECIALTY HOSPITAL OF PITTSBURGH STEUBENVILLE PIKE OAKDALE |
$399 | — | — | — | — | — | — | — | $116 |
| PAM HEALTH SPECIALTY HOSPITAL OF PITTSBURGH STEUBENVILLE PIKE OAKDALE |
$399 | — | — | — | — | — | — | — | $116 |
| WAYNE MEMORIAL HOSPITAL PARK ST. HONESDALE |
$436 | $75.00 | $70.00 | $70.00 | — | $100 | $40.00 | — | — |
What these prices are. Each figure is the facility’s own published self-pay (cash) price for CPT 97167, filed under the federal price transparency rule (45 CFR Part 180). Hospital facility charges may not include separate physician, anesthesia, or pathology fees. National median for this code: $277 across all reporting facilities. Dataset: Q4 2026. Always confirm the final price with the facility before booking.
Billed more than $258 for this?
That is the median of what the 78 Pennsylvania hospitals above publish for Evaluation for occupational therapy, typically 1 hour — their own figures, filed under federal law. A bill well above them is evidence you can put in writing.
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Medicare reimbursement benchmark
For CPT 97167 in Pennsylvania, Medicare reimburses about $100 on the 2026 Physician Fee Schedule (non-facility, state average across localities). Hospital cash prices for the same code in Pennsylvania range from $69.20 to $1,193 — that means hospital cash prices are typically 2.6x what Medicare pays. If a self-pay quote you receive is more than 2-3x the Medicare rate, ask the hospital for the cash-discount price in writing.
Frequently asked questions
- How much does evaluation for occupational therapy, typically 1 hour cost in Pennsylvania?
- Cash prices for evaluation for occupational therapy, typically 1 hour (CPT 97167) in Pennsylvania range from $69.20 to $1,193, with a median of $258. Prices vary widely by hospital.
- Where can I find the cheapest evaluation for occupational therapy, typically 1 hour in Pennsylvania?
- The cheapest Pennsylvania hospital published cash price for this procedure is $69.20. Use the table above sorted by cash price to find the lowest-priced facility near you.
- Are these the prices I'll pay?
- These are the rates hospitals publish. Final price depends on your insurance, deductible, and the specific services billed. Always confirm with the facility and your insurer before any procedure.
- Why do prices vary so much between hospitals?
- Hospitals set cash prices independently, and insurance contracts negotiate different rates per payer. Two facilities a few miles apart can charge 5-10x different prices for the same procedure.
- Where does this data come from?
- Federal law (45 CFR § 180) requires hospitals to publish their pricing in a machine-readable file. We aggregate these files and republish in a consumer-friendly format.
Evaluation for occupational therapy, typically 1 hour in nearby states
Other procedures in Pennsylvania
Methodology. Cash prices and insurance-negotiated rates published by each Pennsylvania facility under federal price transparency rules (45 CFR § 180). CPT code 97167 (Doctor Visits). Data refreshed regularly; verify with the facility before any procedure.