Repair tendon extensor foot 1/2 each tendon at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$9,012.00
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.
$15,020.00
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.
$302.26 with Highmark Wholecare (prev Gateway) vs $12,767.00 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $302.26 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $302.26 | ↓ -97% |
| UPMC Health Plan | Managed Medicaid | $309.40 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $324.16 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $346.67 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $900.45 | ↓ -90% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -89% |
| Prime Net | Managed Medicare | $2,012.68 | ↓ -78% |
| UPMC Health Plan | CHIP | $2,636.09 | ↓ -71% |
| Keystone Health Plan | Medicare Advantage | $3,004.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $3,004.00 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $3,085.16 | ↓ -66% |
| Aetna | Medicare | $3,250.32 | ↓ -64% |
| Cigna | Medicare | $3,272.14 | ↓ -64% |
| Geisinger | Medicare | $3,272.14 | ↓ -64% |
| United Healthcare | Medicare | $3,334.46 | ↓ -63% |
| Keystone Autism Services | ACAP | $4,986.11 | ↓ -45% |
| Prime Net | Legacy Commercial | $5,572.42 | ↓ -38% |
| Aetna | ACO | $5,617.48 | ↓ -38% |
| Prime Net | ACO | $5,617.48 | ↓ -38% |
| Prime Net | NonGateKeeper | $6,638.84 | ↓ -26% |
| Aetna | Commercial | $6,683.90 | ↓ -26% |
| Prime Net | GateKeeper | $6,683.90 | ↓ -26% |
| Capital Blue Cross | CHIP | $7,045.88 | ↓ -22% |
| Capital Blue Cross | Commercial | $7,045.88 | ↓ -22% |
| Keystone Health Plan | Commercial | $7,045.88 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $8,261.00 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $9,212.47 | ↑ +2% |
| Highmark BCBS of PA | Medicaid | $9,592.66 | ↑ +6% |
| Highmark BCBS of PA | Commercial | $9,802.07 | ↑ +9% |
| Geisinger | Commercial | $9,835.10 | ↑ +9% |
| UPMC Health Plan | Commercial | $10,514.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $10,874.48 | ↑ +21% |
| Preferred Healthcare System | PPO | $11,265.00 | ↑ +25% |
| Cigna | Commercial | $11,715.60 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $12,767.00 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Repair tendon extensor foot 1/2 each tendon at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $5,245.20 | $249.90 – $7,867.80 |
| UPMC Carlisle | Carlisle | $9,012.00 | $302.26 – $12,767.00 |
| UPMC Cole | Coudersport | $580.80 | $249.90 – $1,192.92 |
| UPMC Community Osteopathic | Harrisburg | $9,012.00 | $302.26 – $12,767.00 |
| UPMC Hamot | Erie | $4,998.60 | $261.80 – $4,499.05 |
| UPMC Hanover | Hanover | $9,012.00 | $302.26 – $4,959.33 |
| UPMC Memorial | York | $9,012.00 | $302.26 – $4,978.02 |
| UPMC Presbyterian | Pittsburgh | $4,561.20 | $261.80 – $3,402.68 |