Inj, sutimlimab-jome, 10 mg at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$52.20
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.
$87.00
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.
$11.66 with Prime Net vs $73.95 with Multiplan — 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $11.66 | ↓ -78% |
| Capital Blue Cross | Medicare Advantage | $17.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $17.40 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $18.67 | ↓ -64% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $18.86 | ↓ -64% |
| Geisinger | Medicaid/CHIP | $18.86 | ↓ -64% |
| Highmark Wholecare (prev Gateway) | Medicaid | $19.24 | ↓ -63% |
| Aetna | Medicare | $19.67 | ↓ -62% |
| Geisinger | Medicare | $19.80 | ↓ -62% |
| Cigna | Medicare | $19.80 | ↓ -62% |
| United Healthcare | Medicare | $20.18 | ↓ -61% |
| UPMC Health Plan | Managed Medicaid | $20.75 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $21.42 | ↓ -59% |
| UPMC Health Plan | CHIP | $23.20 | ↓ -56% |
| Cigna | Commercial | $25.06 | ↓ -52% |
| Keystone Autism Services | ACAP | $30.18 | ↓ -42% |
| Prime Net | Legacy Commercial | $32.28 | ↓ -38% |
| Aetna | ACO | $32.54 | ↓ -38% |
| Prime Net | ACO | $32.54 | ↓ -38% |
| Prime Net | NonGateKeeper | $38.45 | ↓ -26% |
| Aetna | Commercial | $38.72 | ↓ -26% |
| Prime Net | GateKeeper | $38.72 | ↓ -26% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $38.99 | ↓ -25% |
| Keystone Health Plan | Commercial | $40.81 | ↓ -22% |
| Capital Blue Cross | CHIP | $40.81 | ↓ -22% |
| Capital Blue Cross | Commercial | $40.81 | ↓ -22% |
| Highmark BCBS of PA | Commercial | $41.48 | ↓ -21% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $47.85 | ↓ -8% |
| United Healthcare | Commercial | $53.59 | ↑ +3% |
| Geisinger | Commercial | $56.97 | ↑ +9% |
| Highmark BCBS of PA | Medicaid | $58.05 | ↑ +11% |
| UPMC Health Plan | Commercial | $60.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $62.99 | ↑ +21% |
| Preferred Healthcare System | PPO | $65.25 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $73.95 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Inj, sutimlimab-jome, 10 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Northwest | Seneca | not published | $11.91 – $20.37 |
| UPMC Mercy | Pittsburgh | not published | $7.44 – $20.75 |
| UPMC St. Margaret | Pittsburgh | not published | $7.51 – $20.75 |