Esophagoscopy/flex/diagnostic 43200 at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$1,509.00
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.
$2,515.00
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.
$118.71 with Highmark Wholecare (prev Gateway) vs $2,832.40 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 | $118.71 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $118.71 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $121.51 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $127.31 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $136.15 | ↓ -91% |
| Prime Net | Managed Medicare | $337.01 | ↓ -78% |
| Keystone Health Plan | Medicare Advantage | $503.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $503.00 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $506.09 | ↓ -66% |
| Highmark BCBS of PA | Medicare | $891.49 | ↓ -41% |
| Prime Net | Legacy Commercial | $933.07 | ↓ -38% |
| Aetna | Medicare | $939.21 | ↓ -38% |
| Prime Net | ACO | $940.61 | ↓ -38% |
| Aetna | ACO | $940.61 | ↓ -38% |
| Cigna | Medicare | $945.51 | ↓ -37% |
| Geisinger | Medicare | $945.51 | ↓ -37% |
| United Healthcare | Medicare | $963.52 | ↓ -36% |
| Prime Net | NonGateKeeper | $1,111.63 | ↓ -26% |
| Prime Net | GateKeeper | $1,119.17 | ↓ -26% |
| Aetna | Commercial | $1,119.17 | ↓ -26% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,159.35 | ↓ -23% |
| Keystone Health Plan | Commercial | $1,179.79 | ↓ -22% |
| Capital Blue Cross | CHIP | $1,179.79 | ↓ -22% |
| Capital Blue Cross | Commercial | $1,179.79 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $1,383.25 | ↓ -8% |
| Keystone Autism Services | ACAP | $1,440.78 | ↓ -5% |
| Geisinger | Commercial | $1,646.82 | ↑ +9% |
| UPMC Health Plan | CHIP | $1,732.64 | ↑ +15% |
| UPMC Health Plan | Commercial | $1,760.50 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,820.86 | ↑ +21% |
| Preferred Healthcare System | PPO | $1,886.25 | ↑ +25% |
| Cigna | Commercial | $1,961.70 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,137.75 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $2,662.03 | ↑ +76% |
| Highmark BCBS of PA | Medicaid | $2,771.89 | ↑ +84% |
| Highmark BCBS of PA | Commercial | $2,832.40 | ↑ +88% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Esophagoscopy/flex/diagnostic 43200 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,769.00 | $93.47 – $3,692.00 |
| UPMC Carlisle | Carlisle | $1,509.00 | $118.71 – $2,137.75 |
| UPMC Cole | Coudersport | $320.40 | $98.14 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $1,509.00 | $118.71 – $2,137.75 |
| UPMC Hamot | Erie | $2,337.60 | $102.82 – $1,300.05 |
| UPMC Hanover | Hanover | $1,509.00 | $118.71 – $1,433.04 |
| UPMC Horizon-Greenville | Greenville | $2,565.60 | $102.82 – $1,060.34 |
| UPMC Magee | Pittsburgh | $2,410.20 | $102.82 – $965.36 |