Biopsy muscle percutaneous needle at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$2,461.20
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.
$4,102.00
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.
$71.62 with Highmark Wholecare (prev Gateway) vs $4,894.81 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $71.62 | ↓ -97% |
| UPMC Health Plan | Managed Medicaid | $73.31 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $76.13 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $76.80 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $82.14 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $323.98 | ↓ -87% |
| Prime Net | Managed Medicare | $549.67 | ↓ -78% |
| Capital Blue Cross | Medicare Advantage | $820.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $820.40 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -59% |
| Prime Net | Legacy Commercial | $1,521.84 | ↓ -38% |
| Aetna | ACO | $1,534.15 | ↓ -38% |
| Prime Net | ACO | $1,534.15 | ↓ -38% |
| Highmark BCBS of PA | Medicare | $1,540.62 | ↓ -37% |
| Aetna | Medicare | $1,623.10 | ↓ -34% |
| Geisinger | Medicare | $1,633.99 | ↓ -34% |
| Cigna | Medicare | $1,633.99 | ↓ -34% |
| United Healthcare | Medicare | $1,665.11 | ↓ -32% |
| UPMC Health Plan | CHIP | $1,713.66 | ↓ -30% |
| Prime Net | NonGateKeeper | $1,813.08 | ↓ -26% |
| Aetna | Commercial | $1,825.39 | ↓ -26% |
| Prime Net | GateKeeper | $1,825.39 | ↓ -26% |
| Keystone Health Plan | Commercial | $1,924.25 | ↓ -22% |
| Capital Blue Cross | CHIP | $1,924.25 | ↓ -22% |
| Capital Blue Cross | Commercial | $1,924.25 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $2,256.10 | ↓ -8% |
| Keystone Autism Services | ACAP | $2,489.89 | ↑ +1% |
| Geisinger | Commercial | $2,685.99 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,871.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,969.85 | ↑ +21% |
| Preferred Healthcare System | PPO | $3,076.50 | ↑ +25% |
| Cigna | Commercial | $3,397.00 | ↑ +38% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,486.70 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $4,600.38 | ↑ +87% |
| Highmark BCBS of PA | Medicaid | $4,790.23 | ↑ +95% |
| Highmark BCBS of PA | Commercial | $4,894.81 | ↑ +99% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy muscle percutaneous needle at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,452.40 | $56.39 – $4,603.20 |
| UPMC Bedford | Everett | $3,754.80 | $59.21 – $5,632.20 |
| UPMC Carlisle | Carlisle | $2,461.20 | $71.62 – $3,486.70 |
| UPMC Community Osteopathic | Harrisburg | $2,461.20 | $76.13 – $3,486.70 |
| UPMC East | Monroeville | $1,704.60 | $62.03 – $2,272.80 |
| UPMC Hamot | Erie | $2,312.40 | $62.03 – $2,246.66 |
| UPMC Northwest | Seneca | $1,891.20 | $62.03 – $1,621.93 |
| UPMC Hanover | Hanover | $2,461.20 | $71.62 – $2,476.51 |