Ghs simple repair over 30 cm - 12007 at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$660.00
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.
$1,100.00
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.
$116.84 with AmeriHealth Caritas vs $2,298.07 with UPMC Health Plan — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $116.84 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicaid | $116.84 | ↓ -82% |
| UPMC Health Plan | Managed Medicaid | $119.60 | ↓ -82% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $125.30 | ↓ -81% |
| Geisinger | Medicaid/CHIP | $134.01 | ↓ -80% |
| Prime Net | Managed Medicare | $147.40 | ↓ -78% |
| Highmark BCBS of PA | Medicare | $188.93 | ↓ -71% |
| Aetna | Medicare | $199.05 | ↓ -70% |
| Geisinger | Medicare | $200.38 | ↓ -70% |
| Cigna | Medicare | $200.38 | ↓ -70% |
| United Healthcare | Medicare | $204.20 | ↓ -69% |
| Keystone Health Plan | Medicare Advantage | $220.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $220.00 | ↓ -67% |
| Keystone Autism Services | ACAP | $305.34 | ↓ -54% |
| Prime Net | Legacy Commercial | $408.10 | ↓ -38% |
| Aetna | ACO | $411.40 | ↓ -38% |
| Prime Net | ACO | $411.40 | ↓ -38% |
| Prime Net | NonGateKeeper | $486.20 | ↓ -26% |
| Aetna | Commercial | $489.50 | ↓ -26% |
| Prime Net | GateKeeper | $489.50 | ↓ -26% |
| Capital Blue Cross | CHIP | $516.01 | ↓ -22% |
| Capital Blue Cross | Commercial | $516.01 | ↓ -22% |
| Keystone Health Plan | Commercial | $516.01 | ↓ -22% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $564.16 | ↓ -15% |
| UPMC Work Partners | Workers Comp | $575.60 | ↓ -13% |
| Highmark BCBS of PA | Medicaid | $587.44 | ↓ -11% |
| Highmark BCBS of PA | Commercial | $600.27 | ↓ -9% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $605.00 | ↓ -8% |
| Geisinger | Commercial | $720.28 | ↑ +9% |
| UPMC Health Plan | Commercial | $770.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $796.40 | ↑ +21% |
| Preferred Healthcare System | PPO | $825.00 | ↑ +25% |
| Cigna | Commercial | $858.00 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $935.00 | ↑ +42% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +54% |
| UPMC Health Plan | CHIP | $2,298.07 | ↑ +248% |
| 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 simple repair over 30 cm - 12007 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,305.00 | $92.00 – $1,740.00 |
| UPMC Carlisle | Carlisle | $660.00 | $116.84 – $1,016.56 |
| UPMC Cole | Coudersport | $1,693.20 | $96.60 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $660.00 | $116.84 – $2,298.07 |
| UPMC Hamot | Erie | $4,066.80 | $101.20 – $729.80 |
| UPMC Northwest | Seneca | $4,795.80 | $101.20 – $556.24 |
| UPMC Hanover | Hanover | $660.00 | $116.84 – $1,016.56 |
| UPMC Horizon-Greenville | Greenville | $3,606.00 | $101.20 – $556.24 |