Incision of achilles tendon at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$4,284.60
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.
$7,141.00
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.
$231.22 with Highmark Wholecare (prev Gateway) vs $6,069.85 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 | $231.22 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $236.68 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $245.78 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $247.97 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $265.19 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $392.75 | ↓ -91% |
| Prime Net | Managed Medicare | $956.89 | ↓ -78% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,150.18 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $1,428.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,428.20 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $1,521.76 | ↓ -64% |
| Aetna | Medicare | $1,603.23 | ↓ -63% |
| Geisinger | Medicare | $1,613.99 | ↓ -62% |
| Cigna | Medicare | $1,613.99 | ↓ -62% |
| United Healthcare | Medicare | $1,644.73 | ↓ -62% |
| UPMC Health Plan | CHIP | $1,712.93 | ↓ -60% |
| Keystone Autism Services | ACAP | $2,459.41 | ↓ -43% |
| Prime Net | Legacy Commercial | $2,649.31 | ↓ -38% |
| Aetna | ACO | $2,670.73 | ↓ -38% |
| Prime Net | ACO | $2,670.73 | ↓ -38% |
| Prime Net | NonGateKeeper | $3,156.32 | ↓ -26% |
| Prime Net | GateKeeper | $3,177.74 | ↓ -26% |
| Aetna | Commercial | $3,177.74 | ↓ -26% |
| Capital Blue Cross | Commercial | $3,349.84 | ↓ -22% |
| Capital Blue Cross | CHIP | $3,349.84 | ↓ -22% |
| Keystone Health Plan | Commercial | $3,349.84 | ↓ -22% |
| Cigna | Commercial | $3,397.00 | ↓ -21% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $3,927.55 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $4,544.06 | ↑ +6% |
| Geisinger | Commercial | $4,675.93 | ↑ +9% |
| Highmark BCBS of PA | Medicaid | $4,731.59 | ↑ +10% |
| Highmark BCBS of PA | Commercial | $4,834.89 | ↑ +13% |
| UPMC Health Plan | Commercial | $4,998.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $5,170.08 | ↑ +21% |
| Preferred Healthcare System | PPO | $5,355.75 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $6,069.85 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Incision of achilles tendon at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,284.60 | $231.22 – $6,069.85 |
| UPMC Cole | Coudersport | $327.00 | $151.07 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $4,284.60 | $245.78 – $6,069.85 |
| UPMC Hanover | Hanover | $4,284.60 | $231.22 – $2,446.19 |
| UPMC Memorial | York | $4,284.60 | $231.22 – $2,455.41 |
| UPMC Somerset | Somerset | $4,284.60 | $200.27 – $1,525.80 |
| WellSpan Surgery & Rehabilitation Hospital | York PA 17403 | $1,291.20 | $227.58 – $619.00 |
| Uniontown Hospital | Uniontown | $2,853.75 | $200.27 – $3,237.13 |