App high cost ss t/a/l <100sq cm addl <25sq cm at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$372.00
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.
$620.00
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.
$15.37 with Aetna vs $527.00 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 |
|---|---|---|---|
| Aetna | Medicare | $15.37 | ↓ -96% |
| United Healthcare Community Plan for Families | PA Medicaid | $17.93 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $40.29 | ↓ -89% |
| Prime Net | Managed Medicare | $83.08 | ↓ -78% |
| Keystone Health Plan | Medicare Advantage | $124.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $124.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $230.02 | ↓ -38% |
| Aetna | ACO | $231.88 | ↓ -38% |
| Prime Net | ACO | $231.88 | ↓ -38% |
| Prime Net | NonGateKeeper | $274.04 | ↓ -26% |
| Prime Net | GateKeeper | $275.90 | ↓ -26% |
| Aetna | Commercial | $275.90 | ↓ -26% |
| Capital Blue Cross | CHIP | $290.84 | ↓ -22% |
| Capital Blue Cross | Commercial | $290.84 | ↓ -22% |
| Keystone Health Plan | Commercial | $290.84 | ↓ -22% |
| Geisinger | Medicaid/CHIP | $341.00 | ↓ -8% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $341.00 | ↓ -8% |
| Geisinger | Commercial | $405.98 | ↑ +9% |
| UPMC Health Plan | CHIP | $426.78 | ↑ +15% |
| UPMC Health Plan | Commercial | $434.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $448.88 | ↑ +21% |
| Preferred Healthcare System | PPO | $465.00 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $527.00 | ↑ +42% |
Visitor-reported prices
Comments
App high cost ss t/a/l <100sq cm addl <25sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,472.40 | $38.50 – $1,963.20 |
| UPMC Carlisle | Carlisle | $372.00 | $17.93 – $527.00 |
| UPMC Hamot | Erie | $168.60 | $38.50 – $529.86 |
| UPMC Hanover | Hanover | $372.00 | $17.93 – $426.78 |
| UPMC Horizon-Greenville | Greenville | $345.00 | $38.50 – $231.51 |
| UPMC Jameson | New Castle | $345.00 | $15.37 – $426.78 |
| UPMC McKeesport | Mckeesport | $384.00 | $16.91 – $153.12 |
| UPMC Mercy | Pittsburgh | $384.00 | $42.90 – $268.13 |