Perq plmt bile duct stent at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$14,191.20
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.
$23,652.00
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.
$341.01 with Highmark Wholecare (prev Gateway) vs $20,104.20 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 | $341.01 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $349.06 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $362.49 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $365.71 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $391.11 | ↓ -97% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -93% |
| Prime Net | Managed Medicare | $3,169.37 | ↓ -78% |
| Capital Blue Cross | Medicare Advantage | $4,730.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $4,730.40 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $5,547.63 | ↓ -61% |
| Aetna | Medicare | $5,844.63 | ↓ -59% |
| Geisinger | Medicare | $5,883.85 | ↓ -59% |
| Cigna | Medicare | $5,883.85 | ↓ -59% |
| UPMC Work Partners | Workers Comp | $5,989.96 | ↓ -58% |
| United Healthcare | Medicare | $5,995.93 | ↓ -58% |
| Prime Net | Legacy Commercial | $8,774.89 | ↓ -38% |
| Prime Net | ACO | $8,845.85 | ↓ -38% |
| Aetna | ACO | $8,845.85 | ↓ -38% |
| Keystone Autism Services | ACAP | $8,965.87 | ↓ -37% |
| Prime Net | NonGateKeeper | $10,454.18 | ↓ -26% |
| Prime Net | GateKeeper | $10,525.14 | ↓ -26% |
| Aetna | Commercial | $10,525.14 | ↓ -26% |
| Keystone Health Plan | Commercial | $11,095.15 | ↓ -22% |
| Capital Blue Cross | CHIP | $11,095.15 | ↓ -22% |
| Capital Blue Cross | Commercial | $11,095.15 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $13,008.60 | ↓ -8% |
| Geisinger | Commercial | $15,487.33 | ↑ +9% |
| UPMC Health Plan | Commercial | $16,556.40 | ↑ +17% |
| UPMC Health Plan | CHIP | $16,556.40 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $16,565.57 | ↑ +17% |
| Cigna | Commercial | $16,693.00 | ↑ +18% |
| Prime Net | FH-Medical Rental | $17,124.05 | ↑ +21% |
| Highmark BCBS of PA | Medicaid | $17,249.22 | ↑ +22% |
| Highmark BCBS of PA | Commercial | $17,625.78 | ↑ +24% |
| Preferred Healthcare System | PPO | $17,739.00 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $20,104.20 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Perq plmt bile duct stent at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $14,191.20 | $341.01 – $20,104.20 |
| UPMC Community Osteopathic | Harrisburg | $14,191.20 | $362.49 – $20,104.20 |
| UPMC East | Monroeville | $13,188.60 | $295.36 – $17,584.80 |
| UPMC Hamot | Erie | $8,767.80 | $295.36 – $8,090.06 |
| UPMC Hanover | Hanover | $14,191.20 | $341.01 – $8,917.70 |
| UPMC Memorial | York | $14,191.20 | $341.01 – $8,951.31 |
| UPMC Mercy | Pittsburgh | $7,821.60 | $295.36 – $6,653.09 |
| UPMC Passavant-McCandless | Pittsburgh | $20,091.00 | $295.36 – $6,655.51 |