Alys cplx sp/pn npgt w/prgrm at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$369.60
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.
$616.00
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.
$82.25 with AmeriHealth Caritas vs $558.00 with United Healthcare — 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 | $82.25 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicaid | $82.25 | ↓ -78% |
| UPMC Health Plan | Managed Medicaid | $84.19 | ↓ -77% |
| Prime Net | Managed Medicare | $84.39 | ↓ -77% |
| United Healthcare Community Plan for Families | PA Medicaid | $84.84 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $86.93 | ↓ -76% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $86.93 | ↓ -76% |
| Humana | Medicare | $87.81 | ↓ -76% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $88.20 | ↓ -76% |
| Aetna | Medicare | $91.59 | ↓ -75% |
| Cigna | Medicare | $92.20 | ↓ -75% |
| Geisinger | Medicare | $92.20 | ↓ -75% |
| United Healthcare | Medicare | $93.96 | ↓ -75% |
| Geisinger | Medicaid/CHIP | $94.33 | ↓ -74% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $94.83 | ↓ -74% |
| PA Health & Wellness | PA Medicaid HMO | $110.36 | ↓ -70% |
| Keystone Health Plan | Medicare Advantage | $123.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $123.20 | ↓ -67% |
| Keystone Autism Services | ACAP | $140.50 | ↓ -62% |
| UPMC Work Partners | Workers Comp | $154.93 | ↓ -58% |
| UPMC Health Plan | CHIP | $206.08 | ↓ -44% |
| Prime Net | Legacy Commercial | $240.24 | ↓ -35% |
| Prime Net | ACO | $242.09 | ↓ -34% |
| Aetna | ACO | $242.09 | ↓ -34% |
| Highmark BCBS of PA | Community Blue PPO | $246.97 | ↓ -33% |
| Highmark BCBS of PA | CHIP - Managed Care | $257.42 | ↓ -30% |
| Highmark BCBS of PA | Commercial | $274.42 | ↓ -26% |
| Prime Net | NonGateKeeper | $286.44 | ↓ -23% |
| Aetna | Commercial | $288.29 | ↓ -22% |
| Prime Net | GateKeeper | $288.29 | ↓ -22% |
| Capital Blue Cross | CHIP | $336.95 | ↓ -9% |
| Keystone Health Plan | Commercial | $336.95 | ↓ -9% |
| Capital Blue Cross | Commercial | $336.95 | ↓ -9% |
| Wellspan Population Health | PPO | $400.40 | ↑ +8% |
| Geisinger | Commercial | $403.36 | ↑ +9% |
| UPMC Health Plan | Commercial | $431.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $465.70 | ↑ +26% |
| Cigna | Commercial | $480.48 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $523.60 | ↑ +42% |
| United Healthcare | Commercial | $558.00 | ↑ +51% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Alys cplx sp/pn npgt w/prgrm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $151.20 | $42.23 – $201.60 |
| UPMC Community Osteopathic | Harrisburg | $369.60 | $82.25 – $523.60 |
| UPMC Hanover | Hanover | $369.60 | $82.25 – $154.93 |
| UPMC Lititz | Lititz | $369.60 | $82.25 – $154.93 |
| UPMC Magee | Pittsburgh | $1,159.20 | $71.24 – $192.30 |
| UPMC Memorial | York | $369.60 | $82.25 – $155.26 |
| UPMC Mercy | Pittsburgh | $1,074.00 | $71.24 – $190.49 |
| UPMC Passavant-McCandless | Pittsburgh | $999.00 | $71.24 – $192.30 |