Ins/rpl pm gen exist sgl lead at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$18,185.40
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.
$30,309.00
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.
$382.27 with Highmark Wholecare (prev Gateway) vs $25,762.65 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $382.27 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $382.27 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $391.30 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $409.96 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $438.44 | ↓ -98% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $1,163.42 | ↓ -94% |
| Prime Net | Managed Medicare | $4,061.41 | ↓ -78% |
| UPMC Health Plan | CHIP | $5,168.02 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $6,061.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $6,061.80 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $7,869.26 | ↓ -57% |
| Aetna | Medicare | $8,290.55 | ↓ -54% |
| Cigna | Medicare | $8,346.19 | ↓ -54% |
| Geisinger | Medicare | $8,346.19 | ↓ -54% |
| United Healthcare | Medicare | $8,505.16 | ↓ -53% |
| Prime Net | Legacy Commercial | $11,244.64 | ↓ -38% |
| Aetna | ACO | $11,335.57 | ↓ -38% |
| Prime Net | ACO | $11,335.57 | ↓ -38% |
| Keystone Autism Services | ACAP | $12,718.00 | ↓ -30% |
| Prime Net | NonGateKeeper | $13,396.58 | ↓ -26% |
| Aetna | Commercial | $13,487.50 | ↓ -26% |
| Prime Net | GateKeeper | $13,487.50 | ↓ -26% |
| Capital Blue Cross | Commercial | $14,217.95 | ↓ -22% |
| Keystone Health Plan | Commercial | $14,217.95 | ↓ -22% |
| Capital Blue Cross | CHIP | $14,217.95 | ↓ -22% |
| United Healthcare | Commercial | $15,730.37 | ↓ -14% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $16,669.95 | ↓ -8% |
| Geisinger | Commercial | $19,846.33 | ↑ +9% |
| UPMC Health Plan | Commercial | $21,216.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $21,943.72 | ↑ +21% |
| Preferred Healthcare System | PPO | $22,731.75 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $23,498.09 | ↑ +29% |
| Cigna | Commercial | $23,641.02 | ↑ +30% |
| Highmark BCBS of PA | Medicaid | $24,467.84 | ↑ +35% |
| Highmark BCBS of PA | Commercial | $25,002.00 | ↑ +37% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $25,762.65 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl pm gen exist sgl lead at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $5,344.20 | $301.00 – $7,125.60 |
| UPMC Carlisle | Carlisle | $18,185.40 | $382.27 – $25,762.65 |
| UPMC Cole | Coudersport | $541.80 | $250.31 – $1,192.92 |
| UPMC Community Osteopathic | Harrisburg | $18,185.40 | $382.27 – $25,762.65 |
| UPMC East | Monroeville | $6,828.00 | $331.10 – $9,104.00 |
| UPMC Hanover | Hanover | $18,185.40 | $382.27 – $12,649.66 |
| UPMC Memorial | York | $18,185.40 | $382.27 – $12,697.34 |
| UPMC Passavant-McCandless | Pittsburgh | $14,386.80 | $331.10 – $8,679.17 |