Ghs intermed repair 20.1 - 30.0 cm-12036 at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$2,075.40
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.
?
What you pay up front if you don't use insurance.
$3,459.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$116.84 with Highmark Wholecare (prev Gateway) vs $2,940.15 with Multiplan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $116.84 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $116.84 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $119.60 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $125.30 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $134.01 | ↓ -94% |
| Prime Net | Managed Medicare | $463.51 | ↓ -78% |
| Highmark BCBS of PA | Medicare | $582.05 | ↓ -72% |
| Aetna | Medicare | $613.21 | ↓ -70% |
| Geisinger | Medicare | $617.33 | ↓ -70% |
| Cigna | Medicare | $617.33 | ↓ -70% |
| United Healthcare | Medicare | $629.09 | ↓ -70% |
| UPMC Work Partners | Workers Comp | $633.41 | ↓ -69% |
| Keystone Health Plan | Medicare Advantage | $691.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $691.80 | ↓ -67% |
| Keystone Autism Services | ACAP | $940.69 | ↓ -55% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -51% |
| Prime Net | Legacy Commercial | $1,283.29 | ↓ -38% |
| Aetna | ACO | $1,293.67 | ↓ -38% |
| Prime Net | ACO | $1,293.67 | ↓ -38% |
| Prime Net | NonGateKeeper | $1,528.88 | ↓ -26% |
| Prime Net | GateKeeper | $1,539.26 | ↓ -26% |
| Aetna | Commercial | $1,539.26 | ↓ -26% |
| Keystone Health Plan | Commercial | $1,622.62 | ↓ -22% |
| Capital Blue Cross | CHIP | $1,622.62 | ↓ -22% |
| Capital Blue Cross | Commercial | $1,622.62 | ↓ -22% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $1,738.04 | ↓ -16% |
| Highmark BCBS of PA | Medicaid | $1,809.77 | ↓ -13% |
| Highmark BCBS of PA | Commercial | $1,849.28 | ↓ -11% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $1,902.45 | ↓ -8% |
| Geisinger | Commercial | $2,264.95 | ↑ +9% |
| UPMC Health Plan | CHIP | $2,315.54 | ↑ +12% |
| UPMC Health Plan | Commercial | $2,421.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,504.32 | ↑ +21% |
| Preferred Healthcare System | PPO | $2,594.25 | ↑ +25% |
| Cigna | Commercial | $2,698.02 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,940.15 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs intermed repair 20.1 - 30.0 cm-12036 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,781.60 | $92.00 – $3,708.80 |
| UPMC Bedford | Everett | $4,739.40 | $96.60 – $7,109.10 |
| UPMC Carlisle | Carlisle | $2,075.40 | $116.84 – $2,940.15 |
| UPMC Cole | Coudersport | $1,693.20 | $70.69 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $2,075.40 | $116.84 – $2,940.15 |
| UPMC East | Monroeville | $3,063.00 | $101.20 – $4,084.00 |
| UPMC Hamot | Erie | $3,124.20 | $101.20 – $848.80 |
| UPMC Hanover | Hanover | $2,075.40 | $116.84 – $1,016.56 |