Special physics consult at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$892.20
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.
$1,487.00
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.
$122.56 with Highmark Wholecare (prev Gateway) vs $26,132.00 with United Healthcare — 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 | $122.56 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $122.56 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $125.45 | ↓ -86% |
| Highmark BCBS of PA | Medicare | $126.24 | ↓ -86% |
| United Healthcare Community Plan for Families | PA Medicaid | $126.42 | ↓ -86% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $131.43 | ↓ -85% |
| Aetna | Medicare | $133.00 | ↓ -85% |
| Geisinger | Medicare | $133.90 | ↓ -85% |
| Cigna | Medicare | $133.90 | ↓ -85% |
| United Healthcare | Medicare | $136.45 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $140.56 | ↓ -84% |
| Prime Net | Managed Medicare | $199.26 | ↓ -78% |
| Keystone Autism Services | ACAP | $204.03 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $297.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $297.40 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $304.98 | ↓ -66% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $376.97 | ↓ -58% |
| Highmark BCBS of PA | Medicaid | $392.53 | ↓ -56% |
| Highmark BCBS of PA | Commercial | $401.10 | ↓ -55% |
| UPMC Health Plan | CHIP | $480.42 | ↓ -46% |
| Prime Net | Legacy Commercial | $551.68 | ↓ -38% |
| Prime Net | ACO | $556.14 | ↓ -38% |
| Aetna | ACO | $556.14 | ↓ -38% |
| Prime Net | NonGateKeeper | $657.25 | ↓ -26% |
| Aetna | Commercial | $661.72 | ↓ -26% |
| Prime Net | GateKeeper | $661.72 | ↓ -26% |
| Cigna | Commercial | $665.27 | ↓ -25% |
| Capital Blue Cross | CHIP | $697.55 | ↓ -22% |
| Keystone Health Plan | Commercial | $697.55 | ↓ -22% |
| Capital Blue Cross | Commercial | $697.55 | ↓ -22% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $817.85 | ↓ -8% |
| Geisinger | Commercial | $973.69 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,040.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,076.59 | ↑ +21% |
| Preferred Healthcare System | PPO | $1,115.25 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,263.95 | ↑ +42% |
| United Healthcare | Commercial | $26,132.00 | ↑ +2829% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Special physics consult at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $561.60 | $96.50 – $748.80 |
| UPMC Carlisle | Carlisle | $892.20 | $122.56 – $1,263.95 |
| UPMC Community Osteopathic | Harrisburg | $892.20 | $122.56 – $1,263.95 |
| UPMC East | Monroeville | $646.80 | $106.15 – $862.40 |
| UPMC Hamot | Erie | $876.00 | $106.15 – $320.99 |
| UPMC Northwest | Seneca | $564.00 | $106.15 – $296.21 |
| UPMC Horizon-Greenville | Greenville | $456.60 | $106.15 – $296.21 |
| UPMC Magee | Pittsburgh | $1,201.20 | $106.15 – $320.99 |