Incision of tendon sheath at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
not published by hospital
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.
not published by hospital
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.
$280.04 with Highmark Wholecare (prev Gateway) vs $6,413.00 with Cigna — 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 | $280.04 | — |
| UPMC Health Plan | Managed Medicaid | $286.65 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $297.68 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $300.32 | — |
| Geisinger | Medicaid/CHIP | $321.18 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $720.50 | — |
| UPMC Work Partners | Workers Comp | $996.62 | — |
| Highmark BCBS of PA | Medicare | $1,521.76 | — |
| Aetna | Medicare | $1,603.23 | — |
| Cigna | Medicare | $1,613.99 | — |
| Geisinger | Medicare | $1,613.99 | — |
| United Healthcare | Medicare | $1,644.73 | — |
| Keystone Autism Services | ACAP | $2,459.41 | — |
| UPMC Health Plan | CHIP | $2,636.03 | — |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $4,544.06 | — |
| Highmark BCBS of PA | Medicaid | $4,731.59 | — |
| Highmark BCBS of PA | Commercial | $4,834.89 | — |
| Cigna | Commercial | $6,413.00 | — |
| 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
Incision of tendon sheath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $787.80 | $231.53 – $1,192.92 |
| Uniontown Hospital | Uniontown | $1,848.00 | $205.80 – $3,237.13 |
| UPMC Altoona | Altoona | not published | $220.50 – $1,647.86 |
| UPMC Carlisle | Carlisle | not published | $280.04 – $2,449.57 |
| UPMC Community Osteopathic | Harrisburg | not published | $297.68 – $5,805.45 |
| UPMC East | Monroeville | not published | $242.55 – $1,678.38 |
| UPMC Northwest | Seneca | not published | $242.55 – $1,602.09 |
| UPMC Hanover | Hanover | not published | $280.04 – $2,446.19 |