Opn exc/dstr ntra-abd 5 cm/< at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$6,780.00
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.
$11,300.00
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.
$1,161.92 with Aetna vs $9,605.00 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 |
|---|---|---|---|
| Aetna | Medicare | $1,161.92 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $1,248.41 | ↓ -82% |
| Prime Net | Managed Medicare | $1,514.20 | ↓ -78% |
| Keystone Health Plan | Medicare Advantage | $2,260.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,260.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $4,192.30 | ↓ -38% |
| Aetna | ACO | $4,226.20 | ↓ -38% |
| Prime Net | ACO | $4,226.20 | ↓ -38% |
| Prime Net | NonGateKeeper | $4,994.60 | ↓ -26% |
| Aetna | Commercial | $5,028.50 | ↓ -26% |
| Prime Net | GateKeeper | $5,028.50 | ↓ -26% |
| Capital Blue Cross | CHIP | $5,300.83 | ↓ -22% |
| Keystone Health Plan | Commercial | $5,300.83 | ↓ -22% |
| Capital Blue Cross | Commercial | $5,300.83 | ↓ -22% |
| Geisinger | Medicaid/CHIP | $6,215.00 | ↓ -8% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $6,215.00 | ↓ -8% |
| Geisinger | Commercial | $7,399.24 | ↑ +9% |
| UPMC Health Plan | CHIP | $7,910.00 | ↑ +17% |
| UPMC Health Plan | Commercial | $7,910.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $8,181.20 | ↑ +21% |
| Preferred Healthcare System | PPO | $8,475.00 | ↑ +25% |
| Cigna | Commercial | $9,539.00 | ↑ +41% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $9,605.00 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Opn exc/dstr ntra-abd 5 cm/< at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $6,780.00 | $1,248.41 – $9,605.00 |
| UPMC Community Osteopathic | Harrisburg | $6,780.00 | $1,052.00 – $4,471.00 |
| UPMC Hanover | Hanover | $6,780.00 | $1,248.41 – $1,248.41 |
| UPMC Horizon-Greenville | Greenville | $8,245.80 | $846.15 – $1,192.92 |
| UPMC Memorial | York | $6,780.00 | $354.49 – $1,248.41 |
| UPMC Presbyterian | Pittsburgh | $15,525.00 | $439.08 – $1,516.93 |
| UPMC Somerset | Somerset | $6,780.00 | $430.54 – $1,192.92 |