Lumbar diskogram s&i at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$4,030.20
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.
$6,717.00
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.
$47.16 with United Healthcare Community Plan for Families vs $9,036.05 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 | $47.16 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $76.20 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $76.20 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $78.00 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $81.72 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $87.40 | ↓ -98% |
| Premier Comp Solutions | Worker's Comp | $797.48 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $797.48 | ↓ -80% |
| Prime Net | Managed Medicare | $900.08 | ↓ -78% |
| UPMC Health Plan | CHIP | $1,225.95 | ↓ -70% |
| Keystone Health Plan | Medicare Advantage | $1,343.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,343.40 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $1,856.80 | ↓ -54% |
| Aetna | Medicare | $1,956.21 | ↓ -51% |
| Geisinger | Medicare | $1,969.34 | ↓ -51% |
| Cigna | Medicare | $1,969.34 | ↓ -51% |
| United Healthcare | Medicare | $2,006.85 | ↓ -50% |
| Prime Net | Legacy Commercial | $2,492.01 | ↓ -38% |
| Aetna | ACO | $2,512.16 | ↓ -38% |
| Prime Net | ACO | $2,512.16 | ↓ -38% |
| Prime Net | NonGateKeeper | $2,968.91 | ↓ -26% |
| Prime Net | GateKeeper | $2,989.07 | ↓ -26% |
| Aetna | Commercial | $2,989.07 | ↓ -26% |
| Keystone Autism Services | ACAP | $3,000.90 | ↓ -26% |
| Capital Blue Cross | CHIP | $3,150.94 | ↓ -22% |
| Keystone Health Plan | Commercial | $3,150.94 | ↓ -22% |
| Capital Blue Cross | Commercial | $3,150.94 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $3,694.35 | ↓ -8% |
| Geisinger | Commercial | $4,398.29 | ↑ +9% |
| UPMC Health Plan | Commercial | $4,701.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $4,863.11 | ↑ +21% |
| United Healthcare | Commercial | $4,943.71 | ↑ +23% |
| Preferred Healthcare System | PPO | $5,037.75 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $5,544.53 | ↑ +38% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $5,709.45 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $5,773.35 | ↑ +43% |
| Highmark BCBS of PA | Commercial | $5,899.39 | ↑ +46% |
| Cigna | Commercial | $9,036.05 | ↑ +124% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lumbar diskogram s&i at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,030.20 | $47.16 – $5,709.45 |
| UPMC Community Osteopathic | Harrisburg | $4,030.20 | $47.16 – $5,709.45 |
| UPMC Hanover | Hanover | $4,030.20 | $47.16 – $2,984.77 |
| UPMC Memorial | York | $4,030.20 | $47.16 – $2,996.02 |
| UPMC Muncy | Muncy | $1,968.60 | $46.08 – $893.73 |
| UPMC Presbyterian | Pittsburgh | $10,866.00 | $43.20 – $2,047.90 |
| UPMC Somerset | Somerset | $4,030.20 | $41.40 – $1,861.73 |
| UPMC Wellsboro | Wellsboro | $2,380.80 | $46.08 – $762.04 |