Surgical pathology level 4 gross & microscopic examination at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$116.40
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.
$194.00
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.
$11.79 with United Healthcare Community Plan for Families vs $164.12 with UPMC Work Partners — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $11.79 | ↓ -90% |
| Prime Net | Managed Medicare | $17.96 | ↓ -85% |
| Capital Blue Cross | Medicare Advantage | $26.80 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $26.80 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $34.00 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicaid | $43.18 | ↓ -63% |
| UPMC Health Plan | Managed Medicaid | $44.20 | ↓ -62% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $46.31 | ↓ -60% |
| Geisinger | Medicaid/CHIP | $49.52 | ↓ -57% |
| Prime Net | Legacy Commercial | $49.71 | ↓ -57% |
| Prime Net | ACO | $50.12 | ↓ -57% |
| Aetna | ACO | $50.12 | ↓ -57% |
| Highmark BCBS of PA | Medicare | $50.81 | ↓ -56% |
| Aetna | Medicare | $53.53 | ↓ -54% |
| Cigna | Medicare | $53.89 | ↓ -54% |
| Geisinger | Medicare | $53.89 | ↓ -54% |
| United Healthcare | Medicare | $54.91 | ↓ -53% |
| Prime Net | NonGateKeeper | $59.23 | ↓ -49% |
| Prime Net | GateKeeper | $59.63 | ↓ -49% |
| Aetna | Commercial | $59.63 | ↓ -49% |
| Keystone Health Plan | Commercial | $62.86 | ↓ -46% |
| Capital Blue Cross | CHIP | $62.86 | ↓ -46% |
| Capital Blue Cross | Commercial | $62.86 | ↓ -46% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $73.70 | ↓ -37% |
| Keystone Autism Services | ACAP | $82.11 | ↓ -29% |
| Cigna | Commercial | $83.52 | ↓ -28% |
| Geisinger | Commercial | $87.74 | ↓ -25% |
| UPMC Health Plan | Commercial | $93.80 | ↓ -19% |
| Prime Net | FH-Medical Rental | $97.02 | ↓ -17% |
| UPMC Health Plan | CHIP | $100.13 | ↓ -14% |
| Preferred Healthcare System | PPO | $100.50 | ↓ -14% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $113.90 | ↓ -2% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $151.71 | ↑ +30% |
| Highmark BCBS of PA | Medicaid | $157.97 | ↑ +36% |
| Highmark BCBS of PA | Commercial | $161.42 | ↑ +39% |
| UPMC Work Partners | Workers Comp | $164.12 | ↑ +41% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 4 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $197.40 | $9.00 – $263.20 |
| UPMC Bedford | Everett | $100.20 | $18.38 – $156.82 |
| UPMC Carlisle | Carlisle | $116.40 | $11.79 – $164.12 |
| UPMC Cole | Coudersport | $169.20 | $35.70 – $225.60 |
| UPMC Community Osteopathic | Harrisburg | $116.40 | $11.79 – $166.18 |
| UPMC East | Monroeville | $255.60 | $27.54 – $340.80 |
| UPMC Hamot | Erie | $250.20 | $33.11 – $168.74 |
| UPMC Northwest | Seneca | $169.20 | $27.80 – $158.79 |