Surgical pathology level 5 gross & microscopic examination at UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
$664.80
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.
$1,108.00
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.
$15.06 with United Healthcare Community Plan for Families vs $1,086.74 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $15.06 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $45.50 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $57.78 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $59.15 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $61.97 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $66.28 | ↓ -90% |
| UPMC Health Plan | CHIP | $130.59 | ↓ -80% |
| Prime Net | Managed Medicare | $148.47 | ↓ -78% |
| Capital Blue Cross | Medicare Advantage | $221.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $221.60 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $262.75 | ↓ -60% |
| Highmark BCBS of PA | Medicare | $342.05 | ↓ -49% |
| Aetna | Medicare | $360.36 | ↓ -46% |
| Geisinger | Medicare | $362.77 | ↓ -45% |
| Cigna | Medicare | $362.77 | ↓ -45% |
| United Healthcare | Medicare | $369.69 | ↓ -44% |
| Prime Net | Legacy Commercial | $411.07 | ↓ -38% |
| Prime Net | ACO | $414.39 | ↓ -38% |
| Aetna | ACO | $414.39 | ↓ -38% |
| Prime Net | NonGateKeeper | $489.74 | ↓ -26% |
| Prime Net | GateKeeper | $493.06 | ↓ -26% |
| Aetna | Commercial | $493.06 | ↓ -26% |
| Cigna | Commercial | $506.68 | ↓ -24% |
| Keystone Health Plan | Commercial | $519.76 | ↓ -22% |
| Capital Blue Cross | CHIP | $519.76 | ↓ -22% |
| Capital Blue Cross | Commercial | $519.76 | ↓ -22% |
| Keystone Autism Services | ACAP | $552.80 | ↓ -17% |
| Preferred Healthcare System | Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry | $609.40 | ↓ -8% |
| Geisinger | Commercial | $725.52 | ↑ +9% |
| UPMC Health Plan | Commercial | $775.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $802.19 | ↑ +21% |
| Preferred Healthcare System | PPO | $831.00 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $941.80 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $1,021.37 | ↑ +54% |
| Highmark BCBS of PA | Medicaid | $1,063.52 | ↑ +60% |
| Highmark BCBS of PA | Commercial | $1,086.74 | ↑ +63% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $234.60 | $11.50 – $312.80 |
| UPMC Bedford | Everett | $189.60 | $36.42 – $284.40 |
| UPMC Carlisle | Carlisle | $664.80 | $15.06 – $941.80 |
| UPMC Cole | Coudersport | $572.40 | $47.77 – $763.20 |
| UPMC Community Osteopathic | Harrisburg | $664.80 | $15.06 – $378.62 |
| UPMC East | Monroeville | $379.20 | $35.92 – $505.60 |
| UPMC Hamot | Erie | $360.60 | $45.50 – $427.47 |
| UPMC Northwest | Seneca | $360.60 | $36.26 – $360.10 |