Ghs intermed repair over 30 cm - 12037 at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$3,189.00
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.
?
What you pay up front if you don't use insurance.
$5,315.00
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 AmeriHealth Caritas vs $5,526.15 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $116.84 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $116.84 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $119.60 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $125.30 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $134.01 | ↓ -96% |
| Prime Net | Managed Medicare | $712.21 | ↓ -78% |
| UPMC Work Partners | Workers Comp | $774.82 | ↓ -76% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $1,063.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,063.00 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $1,739.33 | ↓ -45% |
| Aetna | Medicare | $1,832.45 | ↓ -43% |
| Geisinger | Medicare | $1,844.74 | ↓ -42% |
| Cigna | Medicare | $1,844.74 | ↓ -42% |
| United Healthcare | Medicare | $1,879.88 | ↓ -41% |
| Prime Net | Legacy Commercial | $1,971.87 | ↓ -38% |
| Aetna | ACO | $1,987.81 | ↓ -38% |
| Prime Net | ACO | $1,987.81 | ↓ -38% |
| UPMC Health Plan | CHIP | $2,297.96 | ↓ -28% |
| Prime Net | NonGateKeeper | $2,349.23 | ↓ -26% |
| Prime Net | GateKeeper | $2,365.18 | ↓ -26% |
| Aetna | Commercial | $2,365.18 | ↓ -26% |
| Capital Blue Cross | Commercial | $2,493.27 | ↓ -22% |
| Capital Blue Cross | CHIP | $2,493.27 | ↓ -22% |
| Keystone Health Plan | Commercial | $2,493.27 | ↓ -22% |
| Keystone Autism Services | ACAP | $2,811.04 | ↓ -12% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $2,923.25 | ↓ -8% |
| Geisinger | Commercial | $3,480.26 | ↑ +9% |
| UPMC Health Plan | Commercial | $3,720.50 | ↑ +17% |
| Prime Net | FH-Medical Rental | $3,848.06 | ↑ +21% |
| Preferred Healthcare System | PPO | $3,986.25 | ↑ +25% |
| Cigna | Commercial | $4,145.70 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,517.75 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $5,193.75 | ↑ +63% |
| Highmark BCBS of PA | Medicaid | $5,408.09 | ↑ +70% |
| Highmark BCBS of PA | Commercial | $5,526.15 | ↑ +73% |
| 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
Ghs intermed repair over 30 cm - 12037 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $4,695.00 | $92.00 – $6,260.00 |
| UPMC Carlisle | Carlisle | $3,189.00 | $116.84 – $4,517.75 |
| UPMC Cole | Coudersport | $1,693.20 | $96.60 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $3,189.00 | $116.84 – $4,517.75 |
| UPMC Hamot | Erie | $4,104.60 | $101.20 – $2,536.45 |
| UPMC Hanover | Hanover | $3,189.00 | $116.84 – $2,795.94 |
| UPMC Memorial | York | $3,189.00 | $116.84 – $2,806.48 |
| UPMC Mercy | Pittsburgh | $4,080.00 | $101.20 – $1,918.35 |