Biopsy skin incisional single lesion at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$1,227.00
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.
$2,045.00
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.
$62.50 with AmeriHealth Caritas vs $3,397.00 with Cigna — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $62.50 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $62.50 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $63.97 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $67.02 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $71.68 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $185.76 | ↓ -85% |
| Prime Net | Managed Medicare | $274.03 | ↓ -78% |
| Keystone Health Plan | Medicare Advantage | $409.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $409.00 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $582.05 | ↓ -53% |
| Aetna | Medicare | $613.21 | ↓ -50% |
| Geisinger | Medicare | $617.33 | ↓ -50% |
| Cigna | Medicare | $617.33 | ↓ -50% |
| United Healthcare | Medicare | $629.09 | ↓ -49% |
| Prime Net | Legacy Commercial | $758.70 | ↓ -38% |
| Prime Net | ACO | $764.83 | ↓ -38% |
| Aetna | ACO | $764.83 | ↓ -38% |
| UPMC Health Plan | CHIP | $852.66 | ↓ -31% |
| Prime Net | NonGateKeeper | $903.89 | ↓ -26% |
| Aetna | Commercial | $910.02 | ↓ -26% |
| Prime Net | GateKeeper | $910.02 | ↓ -26% |
| Keystone Autism Services | ACAP | $940.69 | ↓ -23% |
| Capital Blue Cross | CHIP | $959.31 | ↓ -22% |
| Capital Blue Cross | Commercial | $959.31 | ↓ -22% |
| Keystone Health Plan | Commercial | $959.31 | ↓ -22% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -17% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $1,124.75 | ↓ -8% |
| Geisinger | Commercial | $1,339.07 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,431.50 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,480.58 | ↑ +21% |
| United Healthcare | Commercial | $1,505.12 | ↑ +23% |
| Preferred Healthcare System | PPO | $1,533.75 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $1,738.04 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,738.25 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $1,809.77 | ↑ +47% |
| Highmark BCBS of PA | Commercial | $1,849.28 | ↑ +51% |
| Cigna | Commercial | $3,397.00 | ↑ +177% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy skin incisional single lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $613.80 | $49.21 – $818.40 |
| UPMC Bedford | Everett | $588.60 | $51.67 – $882.90 |
| UPMC Carlisle | Carlisle | $1,227.00 | $62.50 – $1,738.25 |
| UPMC Cole | Coudersport | $87.60 | $40.47 – $2,325.85 |
| UPMC East | Monroeville | $823.80 | $54.13 – $1,098.40 |
| UPMC Hamot | Erie | $857.40 | $54.13 – $848.80 |
| UPMC Hanover | Hanover | $1,227.00 | $62.50 – $1,016.56 |
| UPMC Jameson | New Castle | $394.80 | $54.13 – $892.40 |