Perq rplcmt g-tube req revsn gstrst trk at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$978.00
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.
$1,630.00
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.
$86.61 with Highmark Wholecare (prev Gateway) vs $1,385.50 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 | $86.61 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $86.61 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $88.66 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $92.89 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $99.34 | ↓ -90% |
| Prime Net | Managed Medicare | $218.42 | ↓ -78% |
| Highmark BCBS of PA | Medicare | $231.25 | ↓ -76% |
| Aetna | Medicare | $243.63 | ↓ -75% |
| Geisinger | Medicare | $245.27 | ↓ -75% |
| Cigna | Medicare | $245.27 | ↓ -75% |
| United Healthcare | Medicare | $249.94 | ↓ -74% |
| Capital Blue Cross | Medicare Advantage | $326.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $326.00 | ↓ -67% |
| Keystone Autism Services | ACAP | $373.74 | ↓ -62% |
| UPMC Work Partners | Workers Comp | $405.72 | ↓ -59% |
| Prime Net | Legacy Commercial | $604.73 | ↓ -38% |
| Prime Net | ACO | $609.62 | ↓ -38% |
| Aetna | ACO | $609.62 | ↓ -38% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $690.54 | ↓ -29% |
| Highmark BCBS of PA | Medicaid | $719.04 | ↓ -26% |
| Prime Net | NonGateKeeper | $720.46 | ↓ -26% |
| Aetna | Commercial | $725.35 | ↓ -26% |
| Prime Net | GateKeeper | $725.35 | ↓ -26% |
| Highmark BCBS of PA | Commercial | $734.73 | ↓ -25% |
| Keystone Health Plan | Commercial | $764.63 | ↓ -22% |
| Capital Blue Cross | CHIP | $764.63 | ↓ -22% |
| Capital Blue Cross | Commercial | $764.63 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $896.50 | ↓ -8% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +4% |
| Geisinger | Commercial | $1,067.32 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,141.00 | ↑ +17% |
| UPMC Health Plan | CHIP | $1,141.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,180.12 | ↑ +21% |
| Preferred Healthcare System | PPO | $1,222.50 | ↑ +25% |
| Cigna | Commercial | $1,271.40 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,385.50 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Perq rplcmt g-tube req revsn gstrst trk at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $1,214.40 | $71.61 – $1,821.60 |
| UPMC Carlisle | Carlisle | $978.00 | $86.61 – $1,385.50 |
| UPMC Cole | Coudersport | $1,504.20 | $58.77 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $978.00 | $86.61 – $1,385.50 |
| UPMC East | Monroeville | $2,281.20 | $75.02 – $3,041.60 |
| UPMC Hamot | Erie | $2,313.60 | $75.02 – $387.69 |
| UPMC Hanover | Hanover | $978.00 | $86.61 – $1,016.56 |
| UPMC Jameson | New Castle | $369.60 | $75.02 – $892.40 |