App high cost ss t/a/l >100sq cm 1st 100sq cm at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$4,513.80
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.
$7,523.00
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.
$440.44 with UPMC Work Partners vs $10,944.60 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 | $440.44 | ↓ -90% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -77% |
| Prime Net | Managed Medicare | $1,030.65 | ↓ -77% |
| UPMC Health Plan | CHIP | $1,031.18 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $1,504.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,504.60 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,926.19 | ↓ -57% |
| Prime Net | Legacy Commercial | $2,933.97 | ↓ -35% |
| Aetna | ACO | $2,956.54 | ↓ -34% |
| Prime Net | ACO | $2,956.54 | ↓ -34% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $3,467.14 | ↓ -23% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $3,467.14 | ↓ -23% |
| Prime Net | NonGateKeeper | $3,498.20 | ↓ -22% |
| Humana | Medicare | $3,502.16 | ↓ -22% |
| Prime Net | GateKeeper | $3,520.76 | ↓ -22% |
| Aetna | Commercial | $3,520.76 | ↓ -22% |
| Aetna | Medicare | $3,652.75 | ↓ -19% |
| Cigna | Medicare | $3,677.27 | ↓ -19% |
| Geisinger | Medicare | $3,677.27 | ↓ -19% |
| United Healthcare | Medicare | $3,747.31 | ↓ -17% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,782.33 | ↓ -16% |
| Capital Blue Cross | CHIP | $4,115.08 | ↓ -9% |
| Keystone Health Plan | Commercial | $4,115.08 | ↓ -9% |
| Capital Blue Cross | Commercial | $4,115.08 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $4,137.65 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $4,137.65 | ↓ -8% |
| Wellspan Population Health | PPO | $4,889.95 | ↑ +8% |
| Geisinger | Commercial | $4,926.06 | ↑ +9% |
| UPMC Health Plan | Commercial | $5,266.10 | ↑ +17% |
| Keystone Autism Services | ACAP | $5,603.46 | ↑ +24% |
| Prime Net | FH-Medical Rental | $5,687.39 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $6,394.55 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $9,850.18 | ↑ +118% |
| Highmark BCBS of PA | CHIP - Managed Care | $10,266.93 | ↑ +127% |
| Highmark BCBS of PA | Commercial | $10,944.60 | ↑ +142% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
App high cost ss t/a/l >100sq cm 1st 100sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | $2,618.40 | $420.87 – $5,076.39 |
| UPMC Hanover | Hanover | $4,513.80 | $440.44 – $5,595.71 |
| UPMC Horizon-Greenville | Greenville | $3,868.20 | $420.87 – $3,769.52 |
| UPMC Jameson | New Castle | $3,441.60 | $420.87 – $4,711.90 |
| UPMC Lititz | Lititz | $4,513.80 | $440.44 – $5,625.95 |
| UPMC Magee | Pittsburgh | $3,461.40 | $420.87 – $3,839.33 |
| UPMC McKeesport | Mckeesport | $3,120.60 | $369.97 – $3,839.33 |
| UPMC Passavant-McCandless | Pittsburgh | $3,154.80 | $420.87 – $3,839.33 |