Drain lower leg lesion 27603 at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$5,229.00
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.
$8,715.00
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.
$112.39 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 | $112.39 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $112.39 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $115.05 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $120.54 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $128.91 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $646.31 | ↓ -88% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -81% |
| Prime Net | Managed Medicare | $1,167.81 | ↓ -78% |
| Keystone Health Plan | Medicare Advantage | $1,743.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,743.00 | ↓ -67% |
| UPMC Health Plan | CHIP | $2,317.34 | ↓ -56% |
| Highmark BCBS of PA | Medicare | $2,721.39 | ↓ -48% |
| Aetna | Medicare | $2,867.08 | ↓ -45% |
| Geisinger | Medicare | $2,886.32 | ↓ -45% |
| Cigna | Medicare | $2,886.32 | ↓ -45% |
| United Healthcare | Medicare | $2,941.30 | ↓ -44% |
| Prime Net | Legacy Commercial | $3,233.26 | ↓ -38% |
| Aetna | ACO | $3,259.41 | ↓ -38% |
| Prime Net | ACO | $3,259.41 | ↓ -38% |
| Prime Net | NonGateKeeper | $3,852.03 | ↓ -26% |
| Prime Net | GateKeeper | $3,878.18 | ↓ -26% |
| Aetna | Commercial | $3,878.18 | ↓ -26% |
| Capital Blue Cross | Commercial | $4,088.21 | ↓ -22% |
| Capital Blue Cross | CHIP | $4,088.21 | ↓ -22% |
| Keystone Health Plan | Commercial | $4,088.21 | ↓ -22% |
| Keystone Autism Services | ACAP | $4,398.21 | ↓ -16% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $4,793.25 | ↓ -8% |
| Cigna | Commercial | $5,035.00 | ↓ -4% |
| Geisinger | Commercial | $5,706.58 | ↑ +9% |
| UPMC Health Plan | Commercial | $6,100.50 | ↑ +17% |
| Prime Net | FH-Medical Rental | $6,309.66 | ↑ +21% |
| United Healthcare | Commercial | $6,414.24 | ↑ +23% |
| Preferred Healthcare System | PPO | $6,536.25 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $7,407.75 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $8,126.24 | ↑ +55% |
| Highmark BCBS of PA | Medicaid | $8,461.60 | ↑ +62% |
| Highmark BCBS of PA | Commercial | $8,646.33 | ↑ +65% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Drain lower leg lesion 27603 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $5,229.00 | $112.39 – $7,407.75 |
| UPMC Cole | Coudersport | $670.80 | $92.92 – $1,041.88 |
| UPMC Hanover | Hanover | $5,229.00 | $112.39 – $4,374.59 |
| WellSpan Chambersburg Hospital | Chambersburg | $3,980.80 | $110.63 – $13,162.83 |
| UPMC Community Osteopathic | Harrisburg | not published | $119.47 – $5,805.45 |
| UPMC Hamot | Erie | not published | $97.35 – $3,968.58 |
| UPMC Northwest | Seneca | not published | $97.35 – $2,865.05 |
| UPMC Somerset | Somerset | not published | $97.35 – $2,728.62 |