Clsd tx prox fib/shaft fx w/manip 27781 at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$2,322.60
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.
$3,871.00
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.
$250.19 with Highmark Wholecare (prev Gateway) vs $4,834.89 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 | $250.19 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $250.19 | ↓ -89% |
| UPMC Health Plan | Managed Medicaid | $256.10 | ↓ -89% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $268.31 | ↓ -88% |
| Geisinger | Medicaid/CHIP | $286.95 | ↓ -88% |
| Prime Net | Managed Medicare | $518.71 | ↓ -78% |
| Keystone Health Plan | Medicare Advantage | $774.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $774.20 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $900.50 | ↓ -61% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -56% |
| Prime Net | Legacy Commercial | $1,436.14 | ↓ -38% |
| Aetna | ACO | $1,447.75 | ↓ -38% |
| Prime Net | ACO | $1,447.75 | ↓ -38% |
| Highmark BCBS of PA | Medicare | $1,521.76 | ↓ -34% |
| Aetna | Medicare | $1,603.23 | ↓ -31% |
| Geisinger | Medicare | $1,613.99 | ↓ -31% |
| Cigna | Medicare | $1,613.99 | ↓ -31% |
| United Healthcare | Medicare | $1,644.73 | ↓ -29% |
| Prime Net | NonGateKeeper | $1,710.98 | ↓ -26% |
| Aetna | Commercial | $1,722.60 | ↓ -26% |
| Prime Net | GateKeeper | $1,722.60 | ↓ -26% |
| UPMC Health Plan | CHIP | $1,730.46 | ↓ -25% |
| Capital Blue Cross | CHIP | $1,815.89 | ↓ -22% |
| Capital Blue Cross | Commercial | $1,815.89 | ↓ -22% |
| Keystone Health Plan | Commercial | $1,815.89 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $2,129.05 | ↓ -8% |
| Keystone Autism Services | ACAP | $2,459.41 | ↑ +6% |
| Geisinger | Commercial | $2,534.73 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,709.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,802.60 | ↑ +21% |
| Preferred Healthcare System | PPO | $2,903.25 | ↑ +25% |
| Cigna | Commercial | $3,019.38 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,290.35 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $4,544.06 | ↑ +96% |
| Highmark BCBS of PA | Medicaid | $4,731.59 | ↑ +104% |
| Highmark BCBS of PA | Commercial | $4,834.89 | ↑ +108% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx prox fib/shaft fx w/manip 27781 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,275.20 | $197.00 – $3,033.60 |
| UPMC Carlisle | Carlisle | $2,322.60 | $250.19 – $3,290.35 |
| UPMC Community Osteopathic | Harrisburg | $2,322.60 | $250.19 – $3,290.35 |
| UPMC Hamot | Erie | $3,162.00 | $216.70 – $2,219.16 |
| UPMC Northwest | Seneca | $3,570.00 | $216.70 – $1,602.09 |
| UPMC Hanover | Hanover | $2,322.60 | $250.19 – $2,446.19 |
| UPMC Horizon-Greenville | Greenville | $2,431.20 | $216.70 – $1,647.86 |
| UPMC Jameson | New Castle | $2,706.00 | $216.70 – $2,059.83 |