Administration vaccine pneumococcal at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$72.60
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.
$121.00
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.
$12.70 with AmeriHealth Caritas vs $137.94 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $12.70 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicaid | $12.70 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $13.00 | ↓ -82% |
| United Healthcare Community Plan for Families | PA Medicaid | $13.10 | ↓ -82% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $13.62 | ↓ -81% |
| Geisinger | Medicaid/CHIP | $14.57 | ↓ -80% |
| Prime Net | Managed Medicare | $16.58 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $17.04 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $24.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $24.20 | ↓ -67% |
| UPMC Health Plan | CHIP | $42.50 | ↓ -41% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $43.70 | ↓ -40% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $43.70 | ↓ -40% |
| Humana | Medicare | $44.14 | ↓ -39% |
| Aetna | Medicare | $46.04 | ↓ -37% |
| Geisinger | Medicare | $46.35 | ↓ -36% |
| Cigna | Medicare | $46.35 | ↓ -36% |
| Prime Net | Legacy Commercial | $47.19 | ↓ -35% |
| United Healthcare | Medicare | $47.23 | ↓ -35% |
| Prime Net | ACO | $47.55 | ↓ -35% |
| Aetna | ACO | $47.55 | ↓ -35% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $47.67 | ↓ -34% |
| Prime Net | NonGateKeeper | $56.27 | ↓ -22% |
| Aetna | Commercial | $56.63 | ↓ -22% |
| Prime Net | GateKeeper | $56.63 | ↓ -22% |
| Capital Blue Cross | CHIP | $66.19 | ↓ -9% |
| Keystone Health Plan | Commercial | $66.19 | ↓ -9% |
| Capital Blue Cross | Commercial | $66.19 | ↓ -9% |
| Keystone Autism Services | ACAP | $70.62 | ↓ -3% |
| Wellspan Population Health | PPO | $78.65 | ↑ +8% |
| Geisinger | Commercial | $79.23 | ↑ +9% |
| UPMC Health Plan | Commercial | $84.70 | ↑ +17% |
| United Healthcare | Commercial | $89.06 | ↑ +23% |
| Prime Net | FH-Medical Rental | $91.48 | ↑ +26% |
| Cigna | Commercial | $94.38 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $102.85 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $124.15 | ↑ +71% |
| Highmark BCBS of PA | CHIP - Managed Care | $129.40 | ↑ +78% |
| Highmark BCBS of PA | Commercial | $137.94 | ↑ +90% |
| 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
Administration vaccine pneumococcal at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $12.00 | $7.53 – $17.04 |
| UPMC Bedford | Everett | $12.00 | $8.00 – $20.88 |
| UPMC Cole | Coudersport | $86.40 | $9.70 – $28.00 |
| UPMC Community Osteopathic | Harrisburg | $72.60 | $7.20 – $48.57 |
| UPMC East | Monroeville | $12.00 | $6.60 – $46.19 |
| UPMC Hamot | Erie | $12.00 | $4.05 – $54.83 |
| UPMC Northwest | Seneca | $12.00 | $11.00 – $46.19 |
| UPMC Hanover | Hanover | $72.60 | $12.70 – $70.53 |