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 |
|---|---|---|---|---|
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $262.80 | $438.00 | $21.61 – $589.04 | 10 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $262.80 | $438.00 | $21.61 – $163.42 | 13 |
| Rib X-ray (3 views, both sides) CPT 71110 | $262.80 | $438.00 | $21.61 – $163.42 | 13 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $106.80 | $178.00 | $0.14 – $0.16 | 5 |
| Right ventric recording CPT 93603 | $2,545.80 | $4,243.00 | $228.36 – $1,865.58 | 9 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | $588.00 | $980.00 | $14.79 – $23.90 | 9 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $55.80 | $93.00 | $74.47 – $120.35 | 9 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | $337.20 | $562.00 | $36.32 – $58.70 | 9 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $50.40 | $84.00 | $29.09 – $47.01 | 9 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $42.60 | $71.00 | $26.24 – $42.42 | 9 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $42.60 | $71.00 | $27.57 – $44.56 | 9 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $2,080.80 | $3,468.00 | $38.73 – $2,489.89 | 12 |
| Rmvl icd by tv extr CPT 33244 | $4,589.40 | $7,649.00 | $1,016.56 – $15,318.41 | 9 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | $34,564.20 | $57,607.00 | $588.20 – $44,742.49 | 9 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $48,933.60 | $81,556.00 | $610.72 – $49,270.19 | 9 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $34,564.20 | $57,607.00 | $565.70 – $34,493.87 | 9 |
| Rmvl icd pulse gen only CPT 33241 | $4,523.40 | $7,539.00 | $497.56 – $5,592.64 | 9 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $2,304.60 | $3,841.00 | $284.94 – $2,769.59 | 9 |
| Rmvl perm pm pulse gen CPT 33233 | $11,583.60 | $19,306.00 | $302.62 – $12,718.00 | 9 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $27,759.00 | $46,265.00 | $400.92 – $1,016.56 | 3 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | $17,467.80 | $29,113.00 | $362.74 – $1,016.56 | 3 |
| Rmvl pq iabp CPT 33968 | $243.00 | $405.00 | $35.27 – $85.20 | 3 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | $512.40 | $854.00 | $148.12 – $312.51 | 3 |
| Rmvl sq defib electrode CPT 33272 | $4,831.80 | $8,053.00 | $624.97 – $5,592.64 | 8 |
| Rmvl subq card rhythm mntr CPT 33286 | $2,304.60 | $3,841.00 | $168.45 – $1,785.22 | 9 |
| Rmvl tv pm lead dual CPT 33235 | $4,523.40 | $7,539.00 | $933.02 – $6,258.11 | 9 |
| Rmvl tv pm lead sgl CPT 33234 | $4,523.40 | $7,539.00 | $978.64 – $5,592.64 | 9 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $1,918.80 | $3,198.00 | $30.47 – $49.25 | 9 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $3,004.80 | $5,008.00 | $10.90 – $17.62 | 9 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $641.40 | $1,069.00 | $11.95 – $19.31 | 9 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $9.00 | $15.00 | $0.05 – $0.11 | 6 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $3,588.60 | $5,981.00 | $572.47 – $2,387.23 | 9 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $1,228.80 | $2,048.00 | $77.29 – $634.34 | 12 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $4,242.60 | $7,071.00 | $426.38 – $2,006.18 | 12 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $4,812.60 | $8,021.00 | $835.74 – $2,241.47 | 12 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $3,217.80 | $5,363.00 | $82.73 – $2,387.23 | 12 |
| Rpl tun-cvad w subq port CPT 36582 | $8,004.00 | $13,340.00 | $348.25 – $4,836.88 | 12 |
| Rpl tun-cvad w subq pump CPT 36583 | $8,004.00 | $13,340.00 | $351.07 – $8,307.14 | 12 |
| Rpl tun cvc wo subq port CPT 36581 | $4,201.80 | $7,003.00 | $236.08 – $4,836.88 | 12 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | not published | not published | $811.95 – $9,588.85 | 9 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | $786.32 – $8,965.87 | 9 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | not published | not published | $603.84 – $9,588.85 | 9 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | $673.80 – $9,588.85 | 9 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | not published | not published | $443.86 – $5,423.23 | 9 |
| Rsv assay w/optic CPT 87807 | $73.80 | $123.00 | $12.31 – $20.96 | 12 |
| Rubella antibody igg CPT 86762 | $80.40 | $134.00 | $14.25 – $26.75 | 12 |
| Rubeola antibody igg CPT 86765 | $72.00 | $120.00 | $11.80 – $20.61 | 12 |
| Russell viper venom diluted CPT 85613 | $48.60 | $81.00 | $9.48 – $15.91 | 12 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $1,441.80 | $2,403.00 | $35.92 – $58.05 | 9 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $262.80 | $438.00 | $21.61 – $163.42 | 13 |
| Salivary gland imaging CPT 78230 | $1,228.80 | $2,048.00 | $51.09 – $617.50 | 12 |
| Salivary glnd img serial img CPT 78231 | $1,228.80 | $2,048.00 | $45.85 – $617.50 | 12 |
| Sarscov coronavirus ag ia CPT 87426 | $84.60 | $141.00 | $17.76 – $56.53 | 12 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $819.60 | $1,366.00 | $118.73 – $429.60 | 12 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $394.20 | $657.00 | $101.12 – $376.32 | 12 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $379.80 | $633.00 | $101.12 – $554.17 | 12 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $394.20 | $657.00 | $101.12 – $378.07 | 12 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $394.20 | $657.00 | $101.12 – $369.30 | 12 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $394.20 | $657.00 | $102.97 – $801.00 | 10 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $2,643.60 | $4,406.00 | $1,198.30 – $2,489.89 | 9 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $885.82 – $4,986.11 | 9 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $189.60 | $316.00 | $21.17 – $143.53 | 8 |
| Screen cerv/vag thin layer HCPCS G0123 | $145.20 | $242.00 | $16.19 – $88.54 | 8 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $664.08 – $2,182.77 | 8 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $664.08 – $2,241.85 | 8 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $100.20 | $167.00 | $17.87 – $28.88 | 11 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $60.00 | $100.00 | $19.00 – $45.23 | 11 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $108.00 | $180.00 | $19.00 – $74.16 | 11 |
| Screening Mammogram CPT 77067 | $257.40 | $429.00 | $98.28 – $506.81 | 8 |
| Screening prostate cancer PSA HCPCS G0103 | $97.80 | $163.00 | $15.43 – $144.59 | 8 |
| Screen pap by tech w md supv HCPCS P3000 | $55.20 | $92.00 | $13.83 – $130.20 | 9 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $394.20 | $657.00 | $57.64 – $223.84 | 13 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $12,577.80 | $20,963.00 | $258.87 – $6,301.51 | 4 |
| Sedimentation rate erythrocyte automated CPT 85652 | $13.80 | $23.00 | $2.67 – $4.32 | 12 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $97.20 | $162.00 | $22.70 – $193.00 | 5 |
| Semen analysis presence/motility CPT 89321 | $86.40 | $144.00 | $9.63 – $35.78 | 9 |
| Serpina1 gene CPT 81332 | $252.00 | $420.00 | $43.21 – $69.84 | 12 |
| Set radiation therapy field CPT 77280 | $655.20 | $1,092.00 | $47.81 – $398.27 | 12 |
| Set radiation therapy field CPT 77285 | $1,029.00 | $1,715.00 | $66.81 – $627.18 | 12 |
| Set radiation therapy field CPT 77290 | $1,273.20 | $2,122.00 | $94.97 – $778.41 | 12 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | $3.60 | $6.00 | $0.01 – $0.22 | 2 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $10.20 | $17.00 | $0.05 – $1.36 | 2 |
| Sex chromatin identification CPT 88130 | $43.20 | $72.00 | $14.37 – $106.57 | 9 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $520.80 | $868.00 | $40.64 – $875.08 | 12 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | $520.80 | $868.00 | $48.26 – $875.08 | 12 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | $819.00 | $1,365.00 | $63.50 – $875.08 | 12 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | $1,341.60 | $2,236.00 | $80.01 – $875.08 | 12 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $520.80 | $868.00 | $35.56 – $875.08 | 12 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $520.80 | $868.00 | $44.45 – $875.08 | 12 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $575.40 | $959.00 | $52.07 – $875.08 | 12 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $520.80 | $868.00 | $31.75 – $875.08 | 12 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | not published | not published | $40.64 – $875.08 | 12 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $660.00 | $1,100.00 | $48.26 – $875.08 | 12 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $1,016.56 – $10,978.03 | 9 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $976.85 – $10,978.03 | 12 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $648.78 – $4,986.11 | 12 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $660.98 – $4,986.11 | 12 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $1,001.12 – $10,978.03 | 12 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $690.25 – $4,986.11 | 12 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $171.60 | $286.00 | $16.13 – $109.38 | 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.