Duplex scan unilateral study 93986 at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$375.60
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.
$626.00
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.
$83.88 with Prime Net vs $589.04 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $83.88 | ↓ -78% |
| Highmark BCBS of PA | Medicare | $101.12 | ↓ -73% |
| Aetna | Medicare | $106.53 | ↓ -72% |
| Cigna | Medicare | $107.25 | ↓ -71% |
| Geisinger | Medicare | $107.25 | ↓ -71% |
| United Healthcare | Medicare | $109.29 | ↓ -71% |
| Capital Blue Cross | Medicare Advantage | $125.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $125.20 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $129.73 | ↓ -65% |
| Highmark Wholecare (prev Gateway) | Medicaid | $151.38 | ↓ -60% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $151.38 | ↓ -60% |
| UPMC Health Plan | Managed Medicaid | $154.96 | ↓ -59% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $162.35 | ↓ -57% |
| Keystone Autism Services | ACAP | $163.42 | ↓ -56% |
| Premier Comp Solutions | Worker's Comp | $165.16 | ↓ -56% |
| UPMC Work Partners | Workers Comp | $165.16 | ↓ -56% |
| Geisinger | Medicaid/CHIP | $173.63 | ↓ -54% |
| Prime Net | Legacy Commercial | $232.25 | ↓ -38% |
| Aetna | ACO | $234.12 | ↓ -38% |
| Prime Net | ACO | $234.12 | ↓ -38% |
| Prime Net | NonGateKeeper | $276.69 | ↓ -26% |
| Prime Net | GateKeeper | $278.57 | ↓ -26% |
| Aetna | Commercial | $278.57 | ↓ -26% |
| Keystone Health Plan | Commercial | $293.66 | ↓ -22% |
| Capital Blue Cross | Commercial | $293.66 | ↓ -22% |
| Capital Blue Cross | CHIP | $293.66 | ↓ -22% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $301.95 | ↓ -20% |
| Highmark BCBS of PA | Medicaid | $314.41 | ↓ -16% |
| Highmark BCBS of PA | Commercial | $321.27 | ↓ -14% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $344.30 | ↓ -8% |
| Geisinger | Commercial | $409.90 | ↑ +9% |
| UPMC Health Plan | Commercial | $438.20 | ↑ +17% |
| UPMC Health Plan | CHIP | $438.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $453.22 | ↑ +21% |
| United Healthcare | Commercial | $460.74 | ↑ +23% |
| Preferred Healthcare System | PPO | $469.50 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $532.10 | ↑ +42% |
| Cigna | Commercial | $589.04 | ↑ +57% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Duplex scan unilateral study 93986 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $493.80 | $76.53 – $658.40 |
| UPMC Bedford | Everett | $406.20 | $36.58 – $609.30 |
| UPMC Carlisle | Carlisle | $375.60 | $85.76 – $532.10 |
| UPMC Community Osteopathic | Harrisburg | $375.60 | $103.55 – $532.10 |
| UPMC East | Monroeville | $395.40 | $77.26 – $527.20 |
| UPMC Hamot | Erie | $615.00 | $76.53 – $179.75 |
| UPMC Northwest | Seneca | $831.00 | $91.94 – $157.82 |
| UPMC Hanover | Hanover | $375.60 | $100.57 – $165.16 |