Plmt biliary drainage cath at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$7,503.60
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.
$12,506.00
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.
$420.81 with Highmark Wholecare (prev Gateway) vs $16,693.00 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $420.81 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $430.75 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $447.32 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $451.30 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $482.64 | ↓ -94% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -86% |
| Prime Net | Managed Medicare | $1,675.80 | ↓ -78% |
| UPMC Work Partners | Workers Comp | $2,214.95 | ↓ -70% |
| Keystone Health Plan | Medicare Advantage | $2,501.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,501.20 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $3,355.62 | ↓ -55% |
| Aetna | Medicare | $3,535.27 | ↓ -53% |
| Geisinger | Medicare | $3,559.00 | ↓ -53% |
| Cigna | Medicare | $3,559.00 | ↓ -53% |
| United Healthcare | Medicare | $3,626.79 | ↓ -52% |
| Prime Net | Legacy Commercial | $4,639.73 | ↓ -38% |
| Prime Net | ACO | $4,677.24 | ↓ -38% |
| Aetna | ACO | $4,677.24 | ↓ -38% |
| Keystone Autism Services | ACAP | $5,423.23 | ↓ -28% |
| Prime Net | NonGateKeeper | $5,527.65 | ↓ -26% |
| Prime Net | GateKeeper | $5,565.17 | ↓ -26% |
| Aetna | Commercial | $5,565.17 | ↓ -26% |
| Capital Blue Cross | Commercial | $5,866.56 | ↓ -22% |
| Capital Blue Cross | CHIP | $5,866.56 | ↓ -22% |
| Keystone Health Plan | Commercial | $5,866.56 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $6,878.30 | ↓ -8% |
| Geisinger | Commercial | $8,188.93 | ↑ +9% |
| UPMC Health Plan | CHIP | $8,754.20 | ↑ +17% |
| UPMC Health Plan | Commercial | $8,754.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $9,054.34 | ↑ +21% |
| Preferred Healthcare System | PPO | $9,379.50 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $10,020.10 | ↑ +34% |
| Highmark BCBS of PA | Medicaid | $10,433.62 | ↑ +39% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $10,630.10 | ↑ +42% |
| Highmark BCBS of PA | Commercial | $10,661.40 | ↑ +42% |
| Cigna | Commercial | $16,693.00 | ↑ +122% |
| 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
Plmt biliary drainage cath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $4,482.60 | $331.35 – $5,976.80 |
| UPMC Carlisle | Carlisle | $7,503.60 | $420.81 – $10,630.10 |
| UPMC Community Osteopathic | Harrisburg | $7,503.60 | $447.32 – $10,630.10 |
| UPMC East | Monroeville | $5,997.60 | $364.49 – $7,996.80 |
| UPMC Hamot | Erie | $5,472.00 | $364.49 – $4,893.48 |
| UPMC Hanover | Hanover | $7,503.60 | $420.81 – $5,394.10 |
| UPMC Magee | Pittsburgh | $4,039.80 | $364.49 – $3,633.70 |
| UPMC McKeesport | Mckeesport | $5,809.80 | $364.49 – $3,700.99 |