Emg 3 ext w-w/o paraspinal area 95863 at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$270.60
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.
$451.00
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.
$32.75 with United Healthcare Community Plan for Families vs $472.66 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $32.75 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $53.98 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicaid | $53.98 | ↓ -80% |
| UPMC Health Plan | Managed Medicaid | $55.25 | ↓ -80% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $57.88 | ↓ -79% |
| Prime Net | Managed Medicare | $60.43 | ↓ -78% |
| Geisinger | Medicaid/CHIP | $61.91 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $90.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $90.20 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $148.77 | ↓ -45% |
| Aetna | Medicare | $156.73 | ↓ -42% |
| Geisinger | Medicare | $157.78 | ↓ -42% |
| Cigna | Medicare | $157.78 | ↓ -42% |
| United Healthcare | Medicare | $160.79 | ↓ -41% |
| Prime Net | Legacy Commercial | $167.32 | ↓ -38% |
| Aetna | ACO | $168.67 | ↓ -38% |
| Prime Net | ACO | $168.67 | ↓ -38% |
| Prime Net | NonGateKeeper | $199.34 | ↓ -26% |
| Prime Net | GateKeeper | $200.69 | ↓ -26% |
| Aetna | Commercial | $200.69 | ↓ -26% |
| Keystone Health Plan | Commercial | $211.56 | ↓ -22% |
| Capital Blue Cross | CHIP | $211.56 | ↓ -22% |
| Capital Blue Cross | Commercial | $211.56 | ↓ -22% |
| Keystone Autism Services | ACAP | $240.43 | ↓ -11% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $248.05 | ↓ -8% |
| Geisinger | Commercial | $295.31 | ↑ +9% |
| UPMC Health Plan | Commercial | $315.70 | ↑ +17% |
| United Healthcare | Commercial | $319.00 | ↑ +18% |
| Prime Net | FH-Medical Rental | $326.52 | ↑ +21% |
| Preferred Healthcare System | PPO | $338.25 | ↑ +25% |
| Cigna | Commercial | $351.78 | ↑ +30% |
| UPMC Health Plan | CHIP | $369.60 | ↑ +37% |
| UPMC Work Partners | Workers Comp | $382.45 | ↑ +41% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $383.35 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $444.23 | ↑ +64% |
| Highmark BCBS of PA | Medicaid | $462.56 | ↑ +71% |
| Highmark BCBS of PA | Commercial | $472.66 | ↑ +75% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Emg 3 ext w-w/o paraspinal area 95863 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $270.60 | $32.75 – $383.35 |
| UPMC Cole | Coudersport | $192.00 | $39.09 – $365.45 |
| UPMC Community Osteopathic | Harrisburg | $270.60 | $32.75 – $387.40 |
| UPMC Hanover | Hanover | $270.60 | $32.75 – $387.40 |
| UPMC Magee | Pittsburgh | $357.00 | $46.75 – $392.67 |
| UPMC Memorial | York | $270.60 | $32.75 – $387.40 |
| UPMC Mercy | Pittsburgh | $447.00 | $46.75 – $398.08 |
| UPMC Presbyterian | Pittsburgh | $1,000.20 | $30.00 – $462.88 |