Angio tib/peroneal/init ves/unila 37228 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$17,281.80
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.
$28,803.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $33,903.02 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -94% |
| Prime Net | Managed Medicare | $3,946.01 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $5,760.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $5,760.60 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $5,966.74 | ↓ -65% |
| UPMC Work Partners | Workers Comp | $8,340.47 | ↓ -52% |
| Cigna | Commercial | $9,539.00 | ↓ -45% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $10,740.13 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $10,740.13 | ↓ -38% |
| Humana | Medicare | $10,848.62 | ↓ -37% |
| Prime Net | Legacy Commercial | $11,233.17 | ↓ -35% |
| Aetna | Medicare | $11,315.11 | ↓ -35% |
| Aetna | ACO | $11,319.58 | ↓ -34% |
| Prime Net | ACO | $11,319.58 | ↓ -34% |
| Geisinger | Medicare | $11,391.05 | ↓ -34% |
| Cigna | Medicare | $11,391.05 | ↓ -34% |
| United Healthcare | Medicare | $11,608.02 | ↓ -33% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11,716.51 | ↓ -32% |
| Prime Net | NonGateKeeper | $13,393.40 | ↓ -22% |
| Aetna | Commercial | $13,479.80 | ↓ -22% |
| Prime Net | GateKeeper | $13,479.80 | ↓ -22% |
| Capital Blue Cross | CHIP | $15,755.24 | ↓ -9% |
| Keystone Health Plan | Commercial | $15,755.24 | ↓ -9% |
| Capital Blue Cross | Commercial | $15,755.24 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $15,841.65 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $15,841.65 | ↓ -8% |
| Keystone Autism Services | ACAP | $17,357.79 | ↑ +0% |
| UPMC Health Plan | CHIP | $18,211.70 | ↑ +5% |
| Wellspan Population Health | PPO | $18,721.95 | ↑ +8% |
| Geisinger | Commercial | $18,860.20 | ↑ +9% |
| UPMC Health Plan | Commercial | $20,162.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $21,775.07 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $24,482.55 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $30,512.83 | ↑ +77% |
| Highmark BCBS of PA | CHIP - Managed Care | $31,803.81 | ↑ +84% |
| Highmark BCBS of PA | Commercial | $33,903.02 | ↑ +96% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Angio tib/peroneal/init ves/unila 37228 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $21,133.20 | $7,969.78 – $28,177.60 |
| UPMC Community Osteopathic | Harrisburg | $17,281.80 | $1,016.56 – $24,482.55 |
| UPMC East | Monroeville | $40,644.00 | $7,969.78 – $54,192.00 |
| UPMC Hamot | Erie | $20,479.20 | $518.43 – $15,725.10 |
| UPMC Northwest | Seneca | $37,266.60 | $7,969.78 – $11,676.82 |
| UPMC Hanover | Hanover | $17,281.80 | $1,016.56 – $18,211.70 |
| UPMC Jameson | New Castle | $17,079.00 | $892.40 – $14,596.02 |
| UPMC Lititz | Lititz | $17,281.80 | $1,016.56 – $18,211.70 |