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 |
|---|---|---|---|---|
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $188.40 | $314.00 | $24.89 – $135.31 | 13 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $1,016.56 – $10,978.03 | 9 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $262.80 | $438.00 | $20.82 – $589.04 | 10 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,713.80 | $4,523.00 | $405.28 – $2,084.90 | 11 |
| Shoulder MRI (with contrast) CPT 73222 | $2,713.80 | $4,523.00 | $327.20 – $3,578.07 | 11 |
| Shoulder MRI (without contrast) CPT 73221 | $1,656.00 | $2,760.00 | $208.69 – $1,224.77 | 11 |
| Shoulder X-ray CPT 73030 | $188.40 | $314.00 | $21.61 – $419.44 | 10 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $188.40 | $314.00 | $18.76 – $419.44 | 10 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $262.80 | $438.00 | $36.93 – $163.42 | 13 |
| Sialography s&i CPT 70390 | $547.80 | $913.00 | $27.51 – $371.46 | 13 |
| Sialolithotomy 42330 CPT 42330 | $3,971.40 | $6,619.00 | $81.28 – $4,983.74 | 12 |
| Sickling rbc CPT 85660 | $28.80 | $48.00 | $3.00 – $8.82 | 12 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $80.86 – $1,401.06 | 12 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $142.24 – $1,811.94 | 12 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $1,016.56 – $1,811.94 | 7 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $81.60 | $136.00 | $123.36 – $187.67 | 6 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,294.80 | $2,158.00 | $131.00 – $808.50 | 14 |
| Sinus CT scan (with contrast) CPT 70487 | $1,294.80 | $2,158.00 | $104.80 – $668.26 | 14 |
| Sinus CT scan (without contrast) CPT 70486 | $796.80 | $1,328.00 | $101.12 – $565.37 | 14 |
| Sinus/juglr venogram s&i CPT 75860 | $5,906.40 | $9,844.00 | $19.65 – $4,836.88 | 13 |
| Sinus X-ray (complete) CPT 70220 | $188.40 | $314.00 | $29.48 – $135.31 | 13 |
| Sinus X-ray (limited) CPT 70210 | $188.40 | $314.00 | $21.61 – $135.31 | 13 |
| Sipuleucel-t - su HCPCS Q2043 | $150.00 | $250.00 | $54,719.60 – $88,435.71 | 9 |
| Sirolimus, oral HCPCS J7520 | $20.40 | $34.00 | $0.87 – $3.76 | 7 |
| Skin Biopsy CPT 11102 | $575.40 | $959.00 | $40.93 – $1,016.56 | 12 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $91.38 – $2,654.34 | 4 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | $3,200.40 | $5,334.00 | $97.30 – $2,638.27 | 4 |
| Skull X-ray (1 to 3 views) CPT 70250 | $262.80 | $438.00 | $27.51 – $163.42 | 13 |
| Skull X-ray (complete) CPT 70260 | $262.80 | $438.00 | $36.01 – $163.42 | 13 |
| Sleep study attended CPT 95807 | $1,830.00 | $3,050.00 | $369.41 – $3,865.00 | 9 |
| Sleep Study (Polysomnography) CPT 95810 | $4,279.20 | $7,132.00 | $354.12 – $1,563.46 | 12 |
| Sleep study unattended CPT 95806 | $984.00 | $1,640.00 | $116.21 – $1,266.05 | 9 |
| Slitting of prepuce CPT 54001 | $4,029.00 | $6,715.00 | $60.96 – $3,148.02 | 12 |
| Slp eval non-spch gen comm dev CPT 92605 | $497.40 | $829.00 | $68.78 – $591.00 | 4 |
| Sm-153 lexidron ther HCPCS A9604 | $5,947.80 | $9,913.00 | $4,271.76 – $26,474.45 | 7 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $427.80 | $713.00 | $29.48 – $273.57 | 13 |
| Small bowel endoscopy CPT 44360 | not published | not published | $172.03 – $2,915.17 | 12 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $189.62 – $2,915.17 | 12 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $30.60 | $51.00 | $3.00 – $8.62 | 12 |
| Smear gram stain CPT 87205 | $24.00 | $40.00 | $4.23 – $6.83 | 12 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $33.00 | $55.00 | $4.50 – $9.58 | 12 |
| Smear wet mount CPT 87210 | $32.40 | $54.00 | $5.76 – $9.31 | 12 |
| Sodium 24 hour urine CPT 84300 | $25.20 | $42.00 | $5.01 – $9.15 | 12 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $3.60 | $6.00 | $2.02 – $3.34 | 6 |
| Sodium serum/plasma/whole blood CPT 84295 | $24.60 | $41.00 | $4.76 – $8.85 | 12 |
| Somatosensory testing CPT 95927 | $583.80 | $973.00 | $42.78 – $478.54 | 12 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $104.86 – $2,380.00 | 2 |
| Special physics consult CPT 77370 | $892.20 | $1,487.00 | $122.56 – $304.98 | 12 |
| Special radiation dosimetry CPT 77331 | $739.80 | $1,233.00 | $22.87 – $204.03 | 12 |
| Special radiation treatment CPT 77470 | $2,055.00 | $3,425.00 | $28.16 – $1,252.58 | 12 |
| Special supplies phys/qhp CPT 99070 | $55.20 | $92.00 | $16.50 – $69.72 | 2 |
| Special teletx port plan CPT 77321 | $939.60 | $1,566.00 | $41.27 – $562.56 | 12 |
| Specific gravity body fluid CPT 84315 | $17.40 | $29.00 | $2.62 – $10.58 | 9 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $865.20 | $1,442.00 | $195.27 – $591.00 | 5 |
| Speech evaluation complex CPT 70371 | $547.80 | $913.00 | $63.43 – $371.46 | 13 |
| Speech Therapy Session (one-on-one) CPT 92507 | $459.00 | $765.00 | $27.56 – $591.00 | 9 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | $110.88 – $111.83 | 2 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $2,461.20 | $4,102.00 | $93.19 – $1,064.22 | 12 |
| Spine X-ray (single view, one level) CPT 72020 | $188.40 | $314.00 | $18.94 – $135.31 | 13 |
| Spleen imaging CPT 78185 | $1,228.80 | $2,048.00 | $51.09 – $617.50 | 12 |
| Splint func pos polyflex ii med HCPCS L3999 | $116.40 | $194.00 | $76.66 – $76.66 | 1 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $5,983.20 | $9,972.00 | $740.15 – $5,625.95 | 9 |
| Split blood or products CPT 86985 | $201.60 | $336.00 | $69.44 – $288.40 | 8 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | $2,538.00 | $4,230.00 | $117.19 – $2,653.62 | 4 |
| Sputum specimen collection CPT 89220 | $1,087.80 | $1,813.00 | $7.03 – $263.33 | 11 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | $5,445.60 | $9,076.00 | $2,323.66 – $6,634.14 | 7 |
| Srs linear based CPT 77372 | $12,437.40 | $20,729.00 | $802.11 – $11,747.57 | 12 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $435.00 | $725.00 | $98.21 – $591.00 | 5 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $601.20 | $1,002.00 | $79.36 – $591.00 | 5 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $24,161.40 | $40,269.00 | $1,016.56 – $27,594.74 | 9 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $17,281.80 | $28,803.00 | $1,016.56 – $17,427.46 | 9 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $8,640.60 | $14,401.00 | $236.46 – $8,744.12 | 3 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | $24,161.40 | $40,269.00 | $1,016.56 – $27,594.74 | 8 |
| St evaluate speech sound production CPT 92522 | $414.00 | $690.00 | $94.15 – $591.00 | 5 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $263.40 | $439.00 | $53.75 – $591.00 | 9 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,228.80 | $2,048.00 | $129.69 – $617.50 | 12 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $520.80 | $868.00 | $25.40 – $242.48 | 12 |
| Strapping of chest CPT 29200 | $378.60 | $631.00 | $44.23 – $242.48 | 12 |
| Strapping of elbow or wrist 29260 CPT 29260 | $204.60 | $341.00 | $39.85 – $91.28 | 12 |
| Strapping of hand or finger CPT 29280 | $204.60 | $341.00 | $45.93 – $282.58 | 9 |
| Strapping of hip CPT 29520 | $411.60 | $686.00 | $41.90 – $198.08 | 12 |
| Strapping of knee CPT 29530 | $411.60 | $686.00 | $32.38 – $198.08 | 12 |
| Strapping of toes 29550 CPT 29550 | $204.60 | $341.00 | $25.40 – $91.28 | 12 |
| Streptozocin injection HCPCS J9320 | $209.40 | $349.00 | $502.27 – $2,599.60 | 3 |
| Stress test pulmonary CPT 94618 | $399.00 | $665.00 | $11.34 – $198.08 | 12 |
| Str markers specimen anal CPT 81265 | $505.20 | $842.00 | $186.24 – $1,872.14 | 9 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $4.80 | $8.00 | $0.92 – $1.16 | 2 |
| Sugars single quant CPT 84378 | $58.80 | $98.00 | $8.15 – $18.45 | 12 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $0.60 | $1.00 | $0.05 – $0.05 | 5 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $105.60 | $176.00 | $37.74 – $160.83 | 4 |
| Surgical pathology level 1 gross examination only CPT 88300 | $54.60 | $91.00 | $1.97 – $37.63 | 12 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $54.60 | $91.00 | $6.55 – $71.72 | 12 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $116.40 | $194.00 | $8.52 – $88.20 | 12 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $116.40 | $194.00 | $11.79 – $164.12 | 12 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $664.80 | $1,108.00 | $15.06 – $552.80 | 12 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $1,472.40 | $2,454.00 | $22.93 – $1,255.36 | 12 |
| Susceptibility agar dilution per agent CPT 87181 | $25.80 | $43.00 | $4.70 – $8.17 | 12 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $25.80 | $43.00 | $4.70 – $7.60 | 12 |
| Susceptibility mic per plate CPT 87186 | $48.60 | $81.00 | $7.03 – $13.84 | 12 |
| Svc venogram s&i CPT 75827 | $1,344.60 | $2,241.00 | $29.48 – $2,387.23 | 13 |
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.