Amputation toe metatarsophalangeal joint at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$6,501.60
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.
$10,836.00
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.
$624.70 with UPMC Work Partners vs $9,699.87 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $624.70 | ↓ -90% |
| United Healthcare Community Plan for Families | PA Medicaid | $956.30 | ↓ -85% |
| Prime Net | Managed Medicare | $1,484.53 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,707.12 | ↓ -74% |
| Capital Blue Cross | Medicare Advantage | $2,167.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $2,167.20 | ↓ -67% |
| UPMC Health Plan | CHIP | $2,297.40 | ↓ -65% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $3,072.82 | ↓ -53% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $3,072.82 | ↓ -53% |
| Humana | Medicare | $3,103.86 | ↓ -52% |
| Aetna | Medicare | $3,237.33 | ↓ -50% |
| Geisinger | Medicare | $3,259.05 | ↓ -50% |
| Cigna | Medicare | $3,259.05 | ↓ -50% |
| United Healthcare | Medicare | $3,321.13 | ↓ -49% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,352.17 | ↓ -48% |
| Prime Net | Legacy Commercial | $4,226.04 | ↓ -35% |
| Aetna | ACO | $4,258.55 | ↓ -34% |
| Prime Net | ACO | $4,258.55 | ↓ -34% |
| Keystone Autism Services | ACAP | $4,966.18 | ↓ -24% |
| Cigna | Commercial | $5,035.00 | ↓ -23% |
| Prime Net | NonGateKeeper | $5,038.74 | ↓ -23% |
| Prime Net | GateKeeper | $5,071.25 | ↓ -22% |
| Aetna | Commercial | $5,071.25 | ↓ -22% |
| Keystone Health Plan | Commercial | $5,927.29 | ↓ -9% |
| Capital Blue Cross | Commercial | $5,927.29 | ↓ -9% |
| Capital Blue Cross | CHIP | $5,927.29 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $5,959.80 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $5,959.80 | ↓ -8% |
| Wellspan Population Health | PPO | $7,043.40 | ↑ +8% |
| Geisinger | Commercial | $7,095.41 | ↑ +9% |
| UPMC Health Plan | Commercial | $7,585.20 | ↑ +17% |
| United Healthcare | Commercial | $7,975.30 | ↑ +23% |
| Prime Net | FH-Medical Rental | $8,192.02 | ↑ +26% |
| Highmark BCBS of PA | Community Blue PPO | $8,729.92 | ↑ +34% |
| Highmark BCBS of PA | CHIP - Managed Care | $9,099.28 | ↑ +40% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $9,210.60 | ↑ +42% |
| Highmark BCBS of PA | Commercial | $9,699.87 | ↑ +49% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Amputation toe metatarsophalangeal joint at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $913.80 | $422.18 – $1,218.40 |
| UPMC Hanover | Hanover | $6,501.60 | $631.99 – $4,959.33 |
| UPMC Lititz | Lititz | $6,501.60 | $624.70 – $4,986.11 |
| Uniontown Hospital | Uniontown | $4,409.50 | $205.80 – $6,587.02 |
| UPMC Altoona | Altoona | not published | $596.93 – $3,340.82 |
| UPMC Bedford | Everett | not published | $596.93 – $3,340.82 |
| UPMC Community Osteopathic | Harrisburg | not published | $631.99 – $5,805.45 |
| UPMC East | Monroeville | not published | $645.49 – $3,402.68 |