healthcosts.net
Lower Back (Lumbar Spine) X-ray at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$262.80
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.
$438.00
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.
$29.48 with United Healthcare Community Plan for Families vs $589.04 with Cigna — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $29.48 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $41.31 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $41.31 | ↓ -84% |
| UPMC Health Plan | Managed Medicaid | $42.29 | ↓ -84% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $44.31 | ↓ -83% |
| Geisinger | Medicaid/CHIP | $47.38 | ↓ -82% |
| Prime Net | Managed Medicare | $58.69 | ↓ -78% |
| Keystone Health Plan | Medicare Advantage | $87.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $87.60 | ↓ -67% |
| Premier Comp Solutions | Worker's Comp | $89.27 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $89.27 | ↓ -66% |
| Highmark BCBS of PA | Medicare | $101.12 | ↓ -62% |
| Aetna | Medicare | $106.53 | ↓ -59% |
| Cigna | Medicare | $107.25 | ↓ -59% |
| Geisinger | Medicare | $107.25 | ↓ -59% |
| United Healthcare | Medicare | $109.29 | ↓ -58% |
| UPMC Health Plan | CHIP | $123.54 | ↓ -53% |
| Prime Net | Legacy Commercial | $162.50 | ↓ -38% |
| Keystone Autism Services | ACAP | $163.42 | ↓ -38% |
| Aetna | ACO | $163.81 | ↓ -38% |
| Prime Net | ACO | $163.81 | ↓ -38% |
| Prime Net | NonGateKeeper | $193.60 | ↓ -26% |
| Prime Net | GateKeeper | $194.91 | ↓ -26% |
| Aetna | Commercial | $194.91 | ↓ -26% |
| Capital Blue Cross | CHIP | $205.47 | ↓ -22% |
| Keystone Health Plan | Commercial | $205.47 | ↓ -22% |
| Capital Blue Cross | Commercial | $205.47 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $240.90 | ↓ -8% |
| Geisinger | Commercial | $286.80 | ↑ +9% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $301.95 | ↑ +15% |
| UPMC Health Plan | Commercial | $306.60 | ↑ +17% |
| Highmark BCBS of PA | Medicaid | $314.41 | ↑ +20% |
| Prime Net | FH-Medical Rental | $317.11 | ↑ +21% |
| Highmark BCBS of PA | Commercial | $321.27 | ↑ +22% |
| United Healthcare | Commercial | $322.37 | ↑ +23% |
| Preferred Healthcare System | PPO | $328.50 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $372.30 | ↑ +42% |
| Cigna | Commercial | $589.04 | ↑ +124% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) X-ray at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $436.20 | $33.98 – $581.60 |
| UPMC Passavant-McCandless | Pittsburgh | $419.40 | $34.28 – $594.15 |
| UPMC Hamot | Erie | $438.00 | $25.96 – $511.00 |
| UPMC Carlisle | Carlisle | $262.80 | $29.48 – $372.30 |
| UPMC Altoona | Altoona | $208.80 | $22.50 – $278.40 |
| UPMC Bedford | Everett | $115.80 | $34.16 – $173.70 |
| UPMC Cole | Coudersport | $171.00 | $34.16 – $228.00 |
| UPMC Community Osteopathic | Harrisburg | $272.40 | $29.48 – $372.30 |