Alpha-fetoprotein amniotic at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$62.40
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.
$104.00
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.
$14.25 with Prime Net vs $88.40 with Multiplan — 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 | $14.25 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $16.83 | ↓ -73% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $16.83 | ↓ -73% |
| Humana | Medicare | $17.00 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $17.59 | ↓ -72% |
| Aetna | Medicare | $17.73 | ↓ -72% |
| Cigna | Medicare | $17.85 | ↓ -71% |
| Geisinger | Medicare | $17.85 | ↓ -71% |
| United Healthcare | Medicare | $18.19 | ↓ -71% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18.36 | ↓ -71% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $20.00 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $20.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $20.80 | ↓ -67% |
| United Healthcare | Commercial | $24.85 | ↓ -60% |
| Highmark Wholecare (prev Gateway) | Medicaid | $25.40 | ↓ -59% |
| UPMC Health Plan | Managed Medicaid | $26.00 | ↓ -58% |
| United Healthcare Community Plan for Families | PA Medicaid | $26.20 | ↓ -58% |
| Keystone Autism Services | ACAP | $27.20 | ↓ -56% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $27.24 | ↓ -56% |
| Geisinger | Medicaid/CHIP | $29.13 | ↓ -53% |
| PA Health & Wellness | PA Medicaid HMO | $34.08 | ↓ -45% |
| Prime Net | Legacy Commercial | $40.56 | ↓ -35% |
| Aetna | ACO | $40.87 | ↓ -35% |
| Prime Net | ACO | $40.87 | ↓ -35% |
| Cigna | Commercial | $44.20 | ↓ -29% |
| Highmark BCBS of PA | Community Blue PPO | $47.81 | ↓ -23% |
| Prime Net | NonGateKeeper | $48.36 | ↓ -23% |
| Aetna | Commercial | $48.67 | ↓ -22% |
| Prime Net | GateKeeper | $48.67 | ↓ -22% |
| Highmark BCBS of PA | CHIP - Managed Care | $49.84 | ↓ -20% |
| Highmark BCBS of PA | Commercial | $53.13 | ↓ -15% |
| Capital Blue Cross | CHIP | $56.89 | ↓ -9% |
| Capital Blue Cross | Commercial | $56.89 | ↓ -9% |
| Keystone Health Plan | Commercial | $56.89 | ↓ -9% |
| Wellspan Population Health | PPO | $67.60 | ↑ +8% |
| Geisinger | Commercial | $68.10 | ↑ +9% |
| UPMC Health Plan | Commercial | $72.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $78.62 | ↑ +26% |
| UPMC Health Plan | CHIP | $84.11 | ↑ +35% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $88.40 | ↑ +42% |
Visitor-reported prices
Comments
Alpha-fetoprotein amniotic at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $160.20 | $16.80 – $213.60 |
| UPMC Bedford | Everett | $203.40 | $6.13 – $305.10 |
| UPMC Community Osteopathic | Harrisburg | $62.40 | $16.83 – $88.40 |
| UPMC East | Monroeville | $141.00 | $16.80 – $188.00 |
| UPMC Hamot | Erie | $183.00 | $16.80 – $32.42 |
| UPMC Northwest | Seneca | $193.80 | $15.42 – $23.00 |
| UPMC Hanover | Hanover | $62.40 | $16.83 – $27.24 |
| UPMC Horizon-Greenville | Greenville | $117.60 | $15.22 – $31.90 |