Abdominal paracentesis w/image guidance at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,225.20
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.
$2,042.00
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.
$107.10 with Highmark Wholecare (prev Gateway) vs $3,397.00 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 | $107.10 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $109.63 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $113.85 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $114.86 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $122.84 | ↓ -90% |
| PA Health & Wellness | PA Medicaid HMO | $143.72 | ↓ -88% |
| Prime Net | Managed Medicare | $279.75 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $408.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $408.40 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $446.96 | ↓ -64% |
| Prime Net | Legacy Commercial | $796.38 | ↓ -35% |
| Prime Net | ACO | $802.51 | ↓ -34% |
| Aetna | ACO | $802.51 | ↓ -34% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $887.92 | ↓ -28% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $887.92 | ↓ -28% |
| Humana | Medicare | $896.89 | ↓ -27% |
| Aetna | Medicare | $935.46 | ↓ -24% |
| Geisinger | Medicare | $941.73 | ↓ -23% |
| Cigna | Medicare | $941.73 | ↓ -23% |
| Prime Net | NonGateKeeper | $949.53 | ↓ -23% |
| Aetna | Commercial | $955.66 | ↓ -22% |
| Prime Net | GateKeeper | $955.66 | ↓ -22% |
| United Healthcare | Medicare | $959.67 | ↓ -22% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $968.64 | ↓ -21% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -17% |
| Capital Blue Cross | CHIP | $1,116.97 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,116.97 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,116.97 | ↓ -9% |
| Wellspan Population Health | PPO | $1,327.30 | ↑ +8% |
| Geisinger | Commercial | $1,337.10 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,429.40 | ↑ +17% |
| Keystone Autism Services | ACAP | $1,435.02 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,543.75 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,735.70 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $2,522.59 | ↑ +106% |
| Highmark BCBS of PA | CHIP - Managed Care | $2,629.32 | ↑ +115% |
| Highmark BCBS of PA | Commercial | $2,802.87 | ↑ +129% |
| UPMC Health Plan | CHIP | $3,102.01 | ↑ +153% |
| Cigna | Commercial | $3,397.00 | ↑ +177% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Abdominal paracentesis w/image guidance at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,179.80 | $84.33 – $2,906.40 |
| UPMC Bedford | Everett | $2,008.20 | $88.55 – $3,012.30 |
| UPMC Cole | Coudersport | $1,693.20 | $57.93 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $1,225.20 | $113.85 – $3,102.01 |
| UPMC East | Monroeville | $2,540.40 | $92.76 – $3,387.20 |
| UPMC Hamot | Erie | $2,052.60 | $92.76 – $1,300.05 |
| UPMC Northwest | Seneca | $1,898.40 | $92.76 – $938.54 |
| UPMC Hanover | Hanover | $1,225.20 | $107.10 – $1,433.04 |