UPMC Lititz
1500 Highlands Drive, Lititz, PA · UPMC · · NPI 1285167916
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $1,230.60 | $2,051.00 | $116.84 – $1,016.56 | 12 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $965.40 | $1,609.00 | $116.84 – $1,016.56 | 12 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $2,079.60 | $3,466.00 | $116.84 – $1,016.56 | 12 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $808.20 | $1,347.00 | $60.33 – $1,016.56 | 12 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $808.20 | $1,347.00 | $61.59 – $966.78 | 12 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $808.20 | $1,347.00 | $78.11 – $719.19 | 12 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $660.00 | $1,100.00 | $116.84 – $1,016.56 | 12 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $660.00 | $1,100.00 | $116.84 – $1,047.17 | 12 |
| Ghs sleep study unattended CPT 95800 | $513.00 | $855.00 | $120.56 – $317.26 | 12 |
| Ghs somatosensory testing lower extremit CPT 95926 | $720.60 | $1,201.00 | $42.52 – $478.54 | 12 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $1,077.00 | $1,795.00 | $241.55 – $815.39 | 12 |
| Ghs sphenopalatine ganglion block CPT 64505 | $2,380.80 | $3,968.00 | $69.22 – $453.63 | 12 |
| Ghs strapping shoulder - 29240 CPT 29240 | $346.20 | $577.00 | $24.77 – $198.08 | 12 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $147.60 | $246.00 | $11.34 – $70.91 | 12 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $522.00 | $870.00 | $79.52 – $323.78 | 12 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $759.00 | $1,265.00 | $119.38 – $1,016.56 | 12 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $1,272.60 | $2,121.00 | $149.86 – $1,016.56 | 12 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $5,073.00 | $8,455.00 | $260.62 – $2,276.34 | 12 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $415.80 | $693.00 | $92.71 – $1,016.56 | 12 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $1,961.40 | $3,269.00 | $228.10 – $1,016.56 | 12 |
| Ghs urine, porphyrins quant CPT 84120 | $75.00 | $125.00 | $7.50 – $23.54 | 12 |
| Ghs vaginal delivery only CPT 59409 | $4,464.60 | $7,441.00 | $471.00 – $4,886.10 | 9 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $1,773.60 | $2,956.00 | $504.52 – $1,089.60 | 11 |
| Giardia ag if CPT 87269 | $75.60 | $126.00 | $12.31 – $21.78 | 12 |
| Giardia lamblia antibody CPT 86674 | $81.60 | $136.00 | $11.76 – $73.30 | 9 |
| Gi inhouse confirmation CPT 87045 | $52.80 | $88.00 | $6.90 – $15.10 | 12 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $1,191.00 | $1,985.00 | $691.01 – $1,731.61 | 12 |
| Glassia injection HCPCS J0257 | $384.00 | $640.00 | $5.58 – $9.02 | 9 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $168.00 | $280.00 | $180.63 – $291.92 | 10 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $167.40 | $279.00 | $147.50 – $239.79 | 10 |
| Glucagon plasma - sendout CPT 82943 | $72.60 | $121.00 | $14.15 – $26.90 | 12 |
| Glucose 1 hr post dose CPT 82950 | $24.00 | $40.00 | $4.70 – $8.89 | 12 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $11.40 | $19.00 | $2.00 – $5.25 | 12 |
| Glucose blood quantitative CPT 82947 | $21.00 | $35.00 | $3.89 – $6.29 | 12 |
| Glucose body fluid CPT 82945 | $21.00 | $35.00 | $3.89 – $6.29 | 12 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $90.60 | $151.00 | $53.52 – $91.28 | 12 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $65.40 | $109.00 | $7.03 – $20.59 | 12 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $20.40 | $34.00 | $3.27 – $6.27 | 12 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $11.40 | $19.00 | $0.46 – $1.51 | 10 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $299.40 | $499.00 | $10.93 – $17.66 | 9 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $94.20 | $157.00 | $17.50 – $29.73 | 12 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $94.20 | $157.00 | $17.00 – $29.63 | 12 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $1,591.80 | $2,653.00 | $726.33 – $1,173.87 | 9 |
| Granisetron hcl injection HCPCS J1626 | $6.00 | $10.00 | $0.19 – $0.54 | 6 |
| Great toe with reduction 28495 CPT 28495 | $759.00 | $1,265.00 | $95.89 – $1,016.56 | 12 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $727.97 – $5,625.95 | 9 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $128.07 – $491.57 | 4 |
| Group mnt 2 or more 30 mins HCPCS G0271 | $67.80 | $113.00 | $12.46 – $115.00 | 3 |
| G-tube reposition CPT 43761 | $978.00 | $1,630.00 | $119.93 – $373.74 | 12 |
| Gu dilat ureter/urethra s&i CPT 74485 | $4,154.40 | $6,924.00 | $101.88 – $3,148.02 | 13 |
| Guided cath fluid drainage 10030 CPT 10030 | $4,608.60 | $7,681.00 | $159.11 – $1,084.86 | 12 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $41.40 | $69.00 | $55.13 – $473.76 | 2 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $92.40 | $154.00 | $0.57 – $504.73 | 2 |
| Guid loc target vol rad tx CPT 77387 | $300.60 | $501.00 | $83.59 – $360.47 | 8 |
| Gw stiffened micro access kit HCPCS C1894 | $256.20 | $427.00 | $82.29 – $418.71 | 2 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $748.43 – $6,274.46 | 9 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $30.60 | $51.00 | $4.40 – $13.33 | 7 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $12.00 | $20.00 | $0.77 – $2.00 | 7 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $160.80 | $268.00 | $18.81 – $148.00 | 9 |
| Hand X-ray CPT 73130 | $188.40 | $314.00 | $15.06 – $419.44 | 10 |
| Hand X-ray (2 views, both hands) CPT 73120 | $262.80 | $438.00 | $13.10 – $589.04 | 10 |
| Haptoglobin quantitative CPT 83010 | $64.20 | $107.00 | $12.00 – $20.13 | 12 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $438.00 | $730.00 | $161.73 – $878.75 | 9 |
| Hbb full gene sequence CPT 81364 | $1,172.40 | $1,954.00 | $259.37 – $519.33 | 8 |
| Hbot, full body chamber, 30m HCPCS G0277 | $544.80 | $908.00 | $55.74 – $211.92 | 11 |
| Hcg qualitative CPT 84703 | $39.00 | $65.00 | $7.44 – $13.97 | 12 |
| Hcg quantitative CPT 84702 | $76.20 | $127.00 | $14.90 – $24.08 | 12 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $184.20 | $307.00 | $66.42 – $438.82 | 3 |
| Hc nm kidney imaging with flow CPT 78701 | $1,228.80 | $2,048.00 | $72.05 – $617.50 | 12 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $1,800.00 | $3,000.00 | $232.45 – $827.18 | 11 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $4,972.20 | $8,287.00 | $800.00 – $2,006.18 | 12 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $3,046.80 | $5,078.00 | $106.15 – $144.75 | 3 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $2,553.60 | $4,256.00 | $216.56 – $1,066.21 | 12 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $2,553.60 | $4,256.00 | $394.40 – $1,066.21 | 12 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $2,553.60 | $4,256.00 | $623.53 – $1,220.40 | 12 |
| Hdr rdncl skn surf brachytx CPT 77767 | $598.20 | $997.00 | $210.11 – $404.13 | 8 |
| Hdr rdncl skn surf brachytx CPT 77768 | $598.20 | $997.00 | $210.11 – $468.86 | 8 |
| Head CT scan (with and without contrast) CPT 70470 | $1,294.80 | $2,158.00 | $131.00 – $787.38 | 14 |
| Head CT scan (with contrast) CPT 70460 | $1,294.80 | $2,158.00 | $104.80 – $646.27 | 14 |
| Head CT scan (without contrast) CPT 70450 | $796.80 | $1,328.00 | $101.12 – $548.60 | 14 |
| Heart infarct image CPT 78466 | $1,228.80 | $2,048.00 | $73.36 – $617.50 | 12 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $188.40 | $314.00 | $15.06 – $419.44 | 10 |
| Helicobacter pylori antibody igm CPT 86677 | $61.20 | $102.00 | $16.68 – $27.31 | 12 |
| Hematocrit CPT 85014 | $12.60 | $21.00 | $2.35 – $4.40 | 12 |
| Hematopoietic nuclear tx CPT 79403 | $918.60 | $1,531.00 | $115.74 – $538.70 | 12 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $6,247.80 | $10,413.00 | $33.84 – $54.69 | 9 |
| Hemodialysis one evaluation CPT 90935 | $1,081.80 | $1,803.00 | $216.15 – $1,145.76 | 9 |
| Hemoglobin CPT 85018 | $12.60 | $21.00 | $2.35 – $4.40 | 12 |
| Hemoglobin fetal qualitative CPT 83033 | $18.00 | $30.00 | $6.53 – $12.80 | 12 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $45.00 | $75.00 | $3.00 – $13.12 | 12 |
| Hemoglobin plasma CPT 83051 | $37.80 | $63.00 | $3.50 – $11.70 | 12 |
| Hemophilus influenza antibdy CPT 86684 | $88.80 | $148.00 | $15.68 – $29.21 | 12 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $2,925.00 | $4,875.00 | $58.42 – $1,401.06 | 12 |
| Hepagam b im injection HCPCS J1571 | $586.80 | $978.00 | $65.97 – $106.62 | 9 |
| Heparin assay CPT 85520 | $66.60 | $111.00 | $6.53 – $20.94 | 12 |
| Heparin bolus from bag HCPCS J1644 | $9.60 | $16.00 | $0.21 – $1.08 | 7 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $1.20 | $2.00 | $0.02 – $0.09 | 7 |
| Hepatitis a antibody igm CPT 86709 | $63.60 | $106.00 | $11.15 – $20.70 | 12 |
| Hepatitis b core antibody igm CPT 86705 | $65.40 | $109.00 | $11.65 – $22.13 | 12 |
| Hepatitis b core antibody total CPT 86704 | $69.60 | $116.00 | $11.93 – $20.43 | 12 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.