healthcosts.net
Abdominal Ultrasound (limited) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$394.20
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.
$657.00
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.
$30.69 with Prime Net vs $589.04 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $30.69 | ↓ -92% |
| Keystone Health Plan | Medicare Advantage | $44.80 | ↓ -89% |
| Capital Blue Cross | Medicare Advantage | $44.80 | ↓ -89% |
| United Healthcare Community Plan for Families | PA Medicaid | $49.12 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $79.38 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $79.38 | ↓ -80% |
| UPMC Health Plan | Managed Medicaid | $81.25 | ↓ -79% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $85.12 | ↓ -78% |
| Prime Net | Legacy Commercial | $87.36 | ↓ -78% |
| Aetna | ACO | $88.03 | ↓ -78% |
| Prime Net | ACO | $88.03 | ↓ -78% |
| Geisinger | Medicaid/CHIP | $91.04 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $100.71 | ↓ -74% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $100.71 | ↓ -74% |
| Humana | Medicare | $101.73 | ↓ -74% |
| Prime Net | NonGateKeeper | $104.16 | ↓ -74% |
| Prime Net | GateKeeper | $104.83 | ↓ -73% |
| Aetna | Commercial | $104.83 | ↓ -73% |
| Aetna | Medicare | $106.10 | ↓ -73% |
| PA Health & Wellness | PA Medicaid HMO | $106.51 | ↓ -73% |
| Cigna | Medicare | $106.82 | ↓ -73% |
| Geisinger | Medicare | $106.82 | ↓ -73% |
| United Healthcare | Medicare | $108.85 | ↓ -72% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $109.87 | ↓ -72% |
| Capital Blue Cross | CHIP | $122.53 | ↓ -69% |
| Keystone Health Plan | Commercial | $122.53 | ↓ -69% |
| Capital Blue Cross | Commercial | $122.53 | ↓ -69% |
| Wellspan Population Health | PPO | $145.60 | ↓ -63% |
| Geisinger | Commercial | $146.68 | ↓ -63% |
| UPMC Health Plan | Commercial | $156.80 | ↓ -60% |
| Keystone Autism Services | ACAP | $162.77 | ↓ -59% |
| United Healthcare | Commercial | $164.86 | ↓ -58% |
| Prime Net | FH-Medical Rental | $169.34 | ↓ -57% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $190.40 | ↓ -52% |
| Premier Comp Solutions | Worker's Comp | $207.72 | ↓ -47% |
| UPMC Work Partners | Workers Comp | $207.72 | ↓ -47% |
| Highmark BCBS of PA | Community Blue PPO | $286.13 | ↓ -27% |
| Highmark BCBS of PA | CHIP - Managed Care | $298.23 | ↓ -24% |
| UPMC Health Plan | CHIP | $299.26 | ↓ -24% |
| Highmark BCBS of PA | Commercial | $317.92 | ↓ -19% |
| Cigna | Commercial | $589.04 | ↑ +49% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Abdominal Ultrasound (limited) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $897.00 | $68.75 – $1,196.00 |
| UPMC Passavant-McCandless | Pittsburgh | $1,039.80 | $68.75 – $1,473.05 |
| UPMC Hamot | Erie | $475.80 | $68.13 – $555.10 |
| UPMC Kane | Kane | $301.80 | $23.45 – $198.49 |
| UPMC Altoona | Altoona | $415.80 | $37.50 – $554.40 |
| UPMC Bedford | Everett | $291.00 | $36.58 – $436.50 |
| UPMC Cole | Coudersport | $280.80 | $65.62 – $374.40 |
| UPMC Community Osteopathic | Harrisburg | $394.20 | $44.80 – $299.26 |