Bone biopsy open superficial at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$5,980.80
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.
$9,968.00
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.
$120.65 with AmeriHealth Caritas vs $8,646.33 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $120.65 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $120.65 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $123.50 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $129.39 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $138.38 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $484.78 | ↓ -92% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,103.02 | ↓ -82% |
| Prime Net | Managed Medicare | $1,335.71 | ↓ -78% |
| Keystone Health Plan | Medicare Advantage | $1,993.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,993.60 | ↓ -67% |
| UPMC Health Plan | CHIP | $2,298.13 | ↓ -62% |
| Highmark BCBS of PA | Medicare | $2,721.39 | ↓ -54% |
| Aetna | Medicare | $2,867.08 | ↓ -52% |
| Geisinger | Medicare | $2,886.32 | ↓ -52% |
| Cigna | Medicare | $2,886.32 | ↓ -52% |
| United Healthcare | Medicare | $2,941.30 | ↓ -51% |
| Prime Net | Legacy Commercial | $3,698.13 | ↓ -38% |
| Aetna | ACO | $3,728.03 | ↓ -38% |
| Prime Net | ACO | $3,728.03 | ↓ -38% |
| Keystone Autism Services | ACAP | $4,398.21 | ↓ -26% |
| Prime Net | NonGateKeeper | $4,405.86 | ↓ -26% |
| Prime Net | GateKeeper | $4,435.76 | ↓ -26% |
| Aetna | Commercial | $4,435.76 | ↓ -26% |
| Capital Blue Cross | Commercial | $4,675.99 | ↓ -22% |
| Capital Blue Cross | CHIP | $4,675.99 | ↓ -22% |
| Keystone Health Plan | Commercial | $4,675.99 | ↓ -22% |
| Cigna | Commercial | $5,035.00 | ↓ -16% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $5,482.40 | ↓ -8% |
| Geisinger | Commercial | $6,527.05 | ↑ +9% |
| UPMC Health Plan | Commercial | $6,977.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $7,216.83 | ↑ +21% |
| Preferred Healthcare System | PPO | $7,476.00 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $8,126.24 | ↑ +36% |
| Highmark BCBS of PA | Medicaid | $8,461.60 | ↑ +41% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $8,472.80 | ↑ +42% |
| Highmark BCBS of PA | Commercial | $8,646.33 | ↑ +45% |
| 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
Bone biopsy open superficial at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $5,980.80 | $120.65 – $8,472.80 |
| UPMC Cole | Coudersport | $515.40 | $99.75 – $1,041.88 |
| UPMC Hamot | Erie | $4,461.00 | $104.50 – $3,968.58 |
| UPMC Hanover | Hanover | $5,980.80 | $120.65 – $4,374.59 |
| UPMC Magee | Pittsburgh | $3,453.60 | $104.50 – $2,946.91 |
| UPMC Passavant-McCandless | Pittsburgh | $5,396.40 | $104.50 – $3,001.48 |
| UPMC Wellsboro | Wellsboro | $5,752.80 | $104.50 – $1,077.76 |
| Uniontown Hospital | Uniontown | $2,317.50 | $104.50 – $5,847.63 |