Xe133 xenon 10mci at UPMC Lititz

1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916

Source: hospital's published price file ↗ · Published Mar 6, 2026 · Ingested Aug 13, 2026

$247.20

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$412.00

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$55.21 with Prime Net vs $373.52 with UPMC Health Plan — 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 →

Payer
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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
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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 $55.21 ↓ -78%
Capital Blue Cross Medicare Advantage $82.40 ↓ -67%
Keystone Health Plan Medicare Advantage $82.40 ↓ -67%
Prime Net Legacy Commercial $152.85 ↓ -38%
Aetna ACO $154.09 ↓ -38%
Prime Net ACO $154.09 ↓ -38%
Prime Net NonGateKeeper $182.10 ↓ -26%
Aetna Commercial $183.34 ↓ -26%
Prime Net GateKeeper $183.34 ↓ -26%
Capital Blue Cross Commercial $193.27 ↓ -22%
Capital Blue Cross CHIP $193.27 ↓ -22%
Keystone Health Plan Commercial $193.27 ↓ -22%
Preferred Healthcare System Inter County Health Plan/Lancaster General Health/Musselman Lumber/Vallorbs Jewelry $226.60 ↓ -8%
Geisinger Medicaid/CHIP $226.60 ↓ -8%
United Healthcare Commercial $253.79 ↑ +3%
Aetna Medicare $260.20 ↑ +5%
Geisinger Commercial $269.78 ↑ +9%
UPMC Health Plan Commercial $288.40 ↑ +17%
Prime Net FH-Medical Rental $298.29 ↑ +21%
Preferred Healthcare System PPO $309.00 ↑ +25%
Cigna Commercial $349.41 ↑ +41%
Multiplan PPO (Includes PHCS and Humana as Payers) $350.20 ↑ +42%
UPMC Health Plan CHIP $373.52 ↑ +51%
UPMC Work Partners Workers Comp not published by hospital —

Visitor-reported prices

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Xe133 xenon 10mci at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Hanover Hanover $247.20 $349.41 – $373.52
UPMC Memorial York $247.20 $42.48 – $373.52
UPMC Presbyterian Pittsburgh $496.20 $73.11 – $603.92

All Pennsylvania hospitals for this procedure →