Abd/low ext cath addl at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$4,321.20
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.
$7,202.00
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.
$61.70 with Highmark Wholecare (prev Gateway) vs $9,539.00 with Cigna — 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $61.70 | ↓ -99% |
| UPMC Health Plan | Managed Medicaid | $63.15 | ↓ -99% |
| United Healthcare Community Plan for Families | PA Medicaid | $63.64 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $65.58 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $66.17 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $70.76 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $82.79 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $148.88 | ↓ -97% |
| UPMC Health Plan | CHIP | $655.14 | ↓ -85% |
| Prime Net | Managed Medicare | $986.67 | ↓ -77% |
| Aetna | Medicare | $1,188.33 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $1,440.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,440.40 | ↓ -67% |
| Prime Net | Legacy Commercial | $2,808.78 | ↓ -35% |
| Prime Net | ACO | $2,830.39 | ↓ -34% |
| Aetna | ACO | $2,830.39 | ↓ -34% |
| Prime Net | NonGateKeeper | $3,348.93 | ↓ -23% |
| Prime Net | GateKeeper | $3,370.54 | ↓ -22% |
| Aetna | Commercial | $3,370.54 | ↓ -22% |
| Capital Blue Cross | CHIP | $3,939.49 | ↓ -9% |
| Capital Blue Cross | Commercial | $3,939.49 | ↓ -9% |
| Keystone Health Plan | Commercial | $3,939.49 | ↓ -9% |
| Wellspan Population Health | PPO | $4,681.30 | ↑ +8% |
| Geisinger | Commercial | $4,715.87 | ↑ +9% |
| UPMC Health Plan | Commercial | $5,041.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $5,444.71 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $6,121.70 | ↑ +42% |
| Cigna | Commercial | $9,539.00 | ↑ +121% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Abd/low ext cath addl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $530.40 | $48.58 – $707.20 |
| UPMC Community Osteopathic | Harrisburg | $4,321.20 | $63.64 – $6,121.70 |
| UPMC East | Monroeville | $1,056.00 | $53.44 – $1,408.00 |
| UPMC Hamot | Erie | $881.40 | $53.44 – $204.47 |
| UPMC Northwest | Seneca | $1,287.00 | $53.44 – $530.67 |
| UPMC Hanover | Hanover | $4,321.20 | $61.70 – $150.62 |
| UPMC Lititz | Lititz | $4,321.20 | $51.23 – $148.88 |
| UPMC Magee | Pittsburgh | $1,179.00 | $53.44 – $206.41 |