Consultation/report referred material w/preparation of slides at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$116.40
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.
$194.00
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.
$13.57 with United Healthcare Community Plan for Families vs $192.25 with UPMC Work Partners — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $13.57 | ↓ -88% |
| Prime Net | Managed Medicare | $26.00 | ↓ -78% |
| Keystone Health Plan | Medicare Advantage | $38.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $38.80 | ↓ -67% |
| UPMC Health Plan | CHIP | $39.31 | ↓ -66% |
| Highmark BCBS of PA | Medicare | $50.81 | ↓ -56% |
| Aetna | Medicare | $53.53 | ↓ -54% |
| Geisinger | Medicare | $53.89 | ↓ -54% |
| Cigna | Medicare | $53.89 | ↓ -54% |
| United Healthcare | Medicare | $54.91 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $63.46 | ↓ -45% |
| Cigna | Commercial | $69.44 | ↓ -40% |
| Prime Net | Legacy Commercial | $71.97 | ↓ -38% |
| Prime Net | ACO | $72.56 | ↓ -38% |
| Aetna | ACO | $72.56 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicaid | $80.59 | ↓ -31% |
| Keystone Autism Services | ACAP | $82.11 | ↓ -29% |
| UPMC Health Plan | Managed Medicaid | $82.50 | ↓ -29% |
| Prime Net | NonGateKeeper | $85.75 | ↓ -26% |
| Prime Net | GateKeeper | $86.33 | ↓ -26% |
| Aetna | Commercial | $86.33 | ↓ -26% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $86.43 | ↓ -26% |
| Capital Blue Cross | Commercial | $91.01 | ↓ -22% |
| Capital Blue Cross | CHIP | $91.01 | ↓ -22% |
| Keystone Health Plan | Commercial | $91.01 | ↓ -22% |
| Geisinger | Medicaid/CHIP | $92.44 | ↓ -21% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $106.70 | ↓ -8% |
| Geisinger | Commercial | $127.03 | ↑ +9% |
| UPMC Health Plan | Commercial | $135.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $140.46 | ↑ +21% |
| Preferred Healthcare System | PPO | $145.50 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $151.71 | ↑ +30% |
| Highmark BCBS of PA | Medicaid | $157.97 | ↑ +36% |
| Highmark BCBS of PA | Commercial | $161.42 | ↑ +39% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $164.90 | ↑ +42% |
| UPMC Work Partners | Workers Comp | $192.25 | ↑ +65% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Consultation/report referred material w/preparation of slides at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $82.80 | $10.36 – $110.40 |
| UPMC Carlisle | Carlisle | $116.40 | $13.57 – $192.25 |
| UPMC Cole | Coudersport | $176.40 | $39.31 – $235.20 |
| UPMC Community Osteopathic | Harrisburg | $116.40 | $13.57 – $185.56 |
| UPMC Hamot | Erie | $102.00 | $16.56 – $176.58 |
| UPMC Hanover | Hanover | $116.40 | $13.57 – $185.56 |
| UPMC Horizon-Greenville | Greenville | $60.60 | $10.95 – $177.31 |
| UPMC Magee | Pittsburgh | $1,295.40 | $11.44 – $176.58 |