2d tee w or without fol w/con,in at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,450.80
Cash price 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.
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What you pay up front if you don't use insurance.
$2,418.00
Gross charge 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.
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The hospital's undiscounted list price — almost no one pays this.
$331.27 with Prime Net vs $2,462.15 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 →
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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 ?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 ?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 | $331.27 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $415.68 | ↓ -71% |
| Keystone Health Plan | Medicare Advantage | $483.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $483.60 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $591.94 | ↓ -59% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $748.23 | ↓ -48% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $748.23 | ↓ -48% |
| Humana | Medicare | $755.79 | ↓ -48% |
| Aetna | Medicare | $788.29 | ↓ -46% |
| Geisinger | Medicare | $793.58 | ↓ -45% |
| Cigna | Medicare | $793.58 | ↓ -45% |
| United Healthcare | Medicare | $808.70 | ↓ -44% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $816.25 | ↓ -44% |
| Prime Net | Legacy Commercial | $943.02 | ↓ -35% |
| Aetna | ACO | $950.27 | ↓ -35% |
| Prime Net | ACO | $950.27 | ↓ -35% |
| Prime Net | NonGateKeeper | $1,124.37 | ↓ -23% |
| Aetna | Commercial | $1,131.62 | ↓ -22% |
| Prime Net | GateKeeper | $1,131.62 | ↓ -22% |
| Keystone Autism Services | ACAP | $1,209.26 | ↓ -17% |
| United Healthcare | Commercial | $1,254.94 | ↓ -14% |
| Capital Blue Cross | Commercial | $1,322.65 | ↓ -9% |
| Capital Blue Cross | CHIP | $1,322.65 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,322.65 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $1,329.90 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $1,329.90 | ↓ -8% |
| Wellspan Population Health | PPO | $1,571.70 | ↑ +8% |
| Geisinger | Commercial | $1,583.31 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,692.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,828.01 | ↑ +26% |
| Cigna | Commercial | $1,886.04 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,055.30 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $2,125.73 | ↑ +47% |
| Highmark BCBS of PA | CHIP - Managed Care | $2,215.67 | ↑ +53% |
| Highmark BCBS of PA | Commercial | $2,361.92 | ↑ +63% |
| UPMC Health Plan | CHIP | $2,462.15 | ↑ +70% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
2d tee w or without fol w/con,in at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,996.20 | $432.45 – $2,661.60 |
| UPMC Bedford | Everett | $852.60 | $271.77 – $1,278.90 |
| UPMC Community Osteopathic | Harrisburg | $1,450.80 | $483.60 – $2,462.15 |
| UPMC East | Monroeville | $2,431.20 | $436.57 – $3,241.60 |
| UPMC Hamot | Erie | $888.00 | $432.45 – $1,010.76 |
| UPMC Northwest | Seneca | $1,641.60 | $683.10 – $813.49 |
| UPMC Horizon-Greenville | Greenville | $2,008.20 | $674.37 – $1,048.86 |
| UPMC Jameson | New Castle | $2,008.20 | $440.08 – $941.54 |