Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC SM153 LEX / 50MCI QUADRAMET
Lititz, PA
See all hospitals reporting HCPCS A9604 →Price type
UPMC Lititz’s median price of $4.7k is 44% below the median hospital's median price ($8.4k), higher than 26% of the 1,373 hospitals reporting HCPCS A9604. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 19 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 2 | Aetna aco facility · percent of total billed charges · inpatientfrom % of charges | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 3 | Aetna aco facility · percent of total billed charges · outpatientfrom % of charges | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
| 4 | Highmark medicare facility · fee schedule · outpatient | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 5 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 6 | Aetna medicare facility · fee schedule · outpatient | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 7 | Cigna medicare facility · fee schedule · outpatient | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 8 | UnitedHealthcare medicare facility · fee schedule · outpatient | $4.6k | $4.6k | — | — | — | $4.6k – $4.6k |
| 9 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $4.6k | $4.6k | — | — | — | $4.6k – $4.6k |
| 10 | Blue Cross Blue Shield chip facility · percent of total billed charges · outpatientfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 11 | Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 12 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 13 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges | $8.4k | $8.4k | — | — | — | $8.4k – $8.4k |
| 14 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges | $8.4k | $8.4k | — | — | — | $8.4k – $8.4k |
| 15 | Highmark commercial - children's health insurance facility · fee schedule · outpatient | $12.8k | $12.8k | — | — | — | $12.8k – $12.8k |
| 16 | Highmark medicaid facility · fee schedule · outpatient | $13.3k | $13.3k | — | — | — | $13.3k – $13.3k |
| 17 | Highmark commercial facility · fee schedule · outpatient | $13.6k | $13.6k | — | — | — | $13.6k – $13.6k |
| 18 | Cigna commercial facility · fee schedule · outpatient | $23.4k | $23.4k | — | — | — | $23.4k – $23.4k |
| 19 | UnitedHealthcare commercial facility · fee schedule · outpatient | $121.2k | $121.2k | — | — | — | $121.2k – $121.2k |
Last updated: Mar 6, 2026
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