#flow interp 9 - 15 markers at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$55.20
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.
$92.00
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.
$12.33 with Prime Net vs $171.72 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 | $12.33 | ↓ -78% |
| Keystone Health Plan | Medicare Advantage | $18.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $18.40 | ↓ -67% |
| Prime Net | Legacy Commercial | $34.13 | ↓ -38% |
| Aetna | ACO | $34.41 | ↓ -38% |
| Prime Net | ACO | $34.41 | ↓ -38% |
| Prime Net | NonGateKeeper | $40.66 | ↓ -26% |
| Prime Net | GateKeeper | $40.94 | ↓ -26% |
| Aetna | Commercial | $40.94 | ↓ -26% |
| Keystone Health Plan | Commercial | $43.16 | ↓ -22% |
| Capital Blue Cross | Commercial | $43.16 | ↓ -22% |
| Capital Blue Cross | CHIP | $43.16 | ↓ -22% |
| Aetna | Medicare | $49.84 | ↓ -10% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $50.60 | ↓ -8% |
| Geisinger | Commercial | $60.24 | ↑ +9% |
| UPMC Health Plan | Commercial | $64.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $66.61 | ↑ +21% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $67.31 | ↑ +22% |
| Preferred Healthcare System | PPO | $69.00 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $78.20 | ↑ +42% |
| Highmark Wholecare (prev Gateway) | Medicaid | $85.48 | ↑ +55% |
| UPMC Health Plan | Managed Medicaid | $87.50 | ↑ +59% |
| United Healthcare Community Plan for Families | PA Medicaid | $88.18 | ↑ +60% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $91.68 | ↑ +66% |
| Geisinger | Medicaid/CHIP | $98.04 | ↑ +78% |
| UPMC Work Partners | Workers Comp | $161.06 | ↑ +192% |
| UPMC Health Plan | CHIP | $166.71 | ↑ +202% |
| Cigna | Commercial | $171.72 | ↑ +211% |
Visitor-reported prices
Comments
#flow interp 9 - 15 markers at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $288.00 | $67.31 – $384.00 |
| UPMC Bedford | Everett | $945.00 | $46.49 – $1,417.50 |
| UPMC Carlisle | Carlisle | $55.20 | $12.60 – $171.72 |
| UPMC Community Osteopathic | Harrisburg | $55.20 | $18.40 – $625.24 |
| UPMC East | Monroeville | $1,141.20 | $45.86 – $1,521.60 |
| UPMC Hamot | Erie | $989.40 | $23.43 – $156.40 |
| UPMC Northwest | Seneca | $303.00 | $46.29 – $405.92 |
| UPMC Hanover | Hanover | $55.20 | $67.31 – $171.72 |