Repair lip full thkns >one-half vert height/cmplx at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$2,046.00
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.
$3,410.00
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.
$456.94 with Prime Net vs $4,474.99 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $456.94 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicaid | $467.69 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $467.69 | ↓ -77% |
| UPMC Health Plan | Managed Medicaid | $478.74 | ↓ -77% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $501.57 | ↓ -75% |
| Geisinger | Medicaid/CHIP | $536.41 | ↓ -74% |
| Keystone Health Plan | Medicare Advantage | $682.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $682.00 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -50% |
| UPMC Work Partners | Workers Comp | $1,193.60 | ↓ -42% |
| Prime Net | Legacy Commercial | $1,265.11 | ↓ -38% |
| Prime Net | ACO | $1,275.34 | ↓ -38% |
| Aetna | ACO | $1,275.34 | ↓ -38% |
| Highmark BCBS of PA | Medicare | $1,408.48 | ↓ -31% |
| Aetna | Medicare | $1,483.89 | ↓ -27% |
| Geisinger | Medicare | $1,493.85 | ↓ -27% |
| Cigna | Medicare | $1,493.85 | ↓ -27% |
| Prime Net | NonGateKeeper | $1,507.22 | ↓ -26% |
| Aetna | Commercial | $1,517.45 | ↓ -26% |
| Prime Net | GateKeeper | $1,517.45 | ↓ -26% |
| United Healthcare | Medicare | $1,522.30 | ↓ -26% |
| Capital Blue Cross | CHIP | $1,599.63 | ↓ -22% |
| Capital Blue Cross | Commercial | $1,599.63 | ↓ -22% |
| Keystone Health Plan | Commercial | $1,599.63 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $1,875.50 | ↓ -8% |
| Geisinger | Commercial | $2,232.87 | ↑ +9% |
| Keystone Autism Services | ACAP | $2,276.34 | ↑ +11% |
| UPMC Health Plan | Commercial | $2,387.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,468.84 | ↑ +21% |
| Preferred Healthcare System | PPO | $2,557.50 | ↑ +25% |
| UPMC Health Plan | CHIP | $2,655.02 | ↑ +30% |
| Cigna | Commercial | $2,659.80 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,898.50 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $4,205.82 | ↑ +106% |
| Highmark BCBS of PA | Medicaid | $4,379.39 | ↑ +114% |
| Highmark BCBS of PA | Commercial | $4,474.99 | ↑ +119% |
| 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
Repair lip full thkns >one-half vert height/cmplx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2,046.00 | $467.17 – $2,898.50 |
| UPMC Community Osteopathic | Harrisburg | $2,046.00 | $467.69 – $2,898.50 |
| UPMC Hamot | Erie | $4,856.40 | $405.09 – $2,053.97 |
| UPMC Hanover | Hanover | $2,046.00 | $467.69 – $2,264.11 |
| UPMC Jameson | New Castle | $3,645.60 | $405.09 – $1,906.50 |
| UPMC McKeesport | Mckeesport | $4,060.80 | $405.09 – $1,600.15 |
| UPMC Memorial | York | $2,046.00 | $467.69 – $2,272.64 |
| UPMC Mercy | Pittsburgh | $3,486.60 | $405.09 – $1,601.90 |