App high cost ss f/n/g/h/f <100sq cm addl <25sq cm at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$288.00
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.
$480.00
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.
$25.78 with United Healthcare Community Plan for Families vs $408.00 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $25.78 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $50.44 | ↓ -82% |
| Prime Net | Managed Medicare | $65.76 | ↓ -77% |
| Aetna | Medicare | $79.20 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $96.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $96.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $187.20 | ↓ -35% |
| Aetna | ACO | $188.64 | ↓ -35% |
| Prime Net | ACO | $188.64 | ↓ -35% |
| Prime Net | NonGateKeeper | $223.20 | ↓ -23% |
| Aetna | Commercial | $224.64 | ↓ -22% |
| Prime Net | GateKeeper | $224.64 | ↓ -22% |
| UPMC Health Plan | CHIP | $234.86 | ↓ -18% |
| Capital Blue Cross | Commercial | $262.56 | ↓ -9% |
| Capital Blue Cross | CHIP | $262.56 | ↓ -9% |
| Keystone Health Plan | Commercial | $262.56 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $264.00 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $264.00 | ↓ -8% |
| Wellspan Population Health | PPO | $312.00 | ↑ +8% |
| Geisinger | Commercial | $314.30 | ↑ +9% |
| UPMC Health Plan | Commercial | $336.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $362.88 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $408.00 | ↑ +42% |
Visitor-reported prices
Comments
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $49.80 | $23.01 – $1,041.88 |
| UPMC Hamot | Erie | $168.60 | $48.19 – $291.59 |
| UPMC Hanover | Hanover | $288.00 | $25.78 – $234.86 |
| UPMC Horizon-Greenville | Greenville | $550.80 | $48.19 – $150.54 |
| UPMC Jameson | New Castle | $550.80 | $22.25 – $234.86 |
| UPMC Lititz | Lititz | $288.00 | $22.25 – $234.86 |
| UPMC McKeesport | Mckeesport | $384.00 | $24.48 – $127.90 |
| UPMC Mercy | Pittsburgh | $384.00 | $53.17 – $129.83 |