Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$817.20
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.
$1,362.00
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.
$47.05 with Highmark Wholecare (prev Gateway) vs $9,539.00 with Cigna — 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $47.05 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $48.16 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $50.02 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $50.46 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $53.97 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $63.14 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $100.30 | ↓ -88% |
| Prime Net | Managed Medicare | $186.59 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $272.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $272.40 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $279.56 | ↓ -66% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $279.56 | ↓ -66% |
| Humana | Medicare | $282.38 | ↓ -65% |
| Aetna | Medicare | $294.52 | ↓ -64% |
| Cigna | Medicare | $296.50 | ↓ -64% |
| Geisinger | Medicare | $296.50 | ↓ -64% |
| United Healthcare | Medicare | $302.15 | ↓ -63% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $304.97 | ↓ -63% |
| Keystone Autism Services | ACAP | $451.81 | ↓ -45% |
| Prime Net | Legacy Commercial | $531.18 | ↓ -35% |
| Aetna | ACO | $535.27 | ↓ -34% |
| Prime Net | ACO | $535.27 | ↓ -34% |
| Prime Net | NonGateKeeper | $633.33 | ↓ -23% |
| Prime Net | GateKeeper | $637.42 | ↓ -22% |
| Aetna | Commercial | $637.42 | ↓ -22% |
| Keystone Health Plan | Commercial | $745.01 | ↓ -9% |
| Capital Blue Cross | Commercial | $745.01 | ↓ -9% |
| Capital Blue Cross | CHIP | $745.01 | ↓ -9% |
| Highmark BCBS of PA | Community Blue PPO | $794.22 | ↓ -3% |
| Highmark BCBS of PA | CHIP - Managed Care | $827.83 | ↑ +1% |
| Highmark BCBS of PA | Commercial | $882.47 | ↑ +8% |
| Wellspan Population Health | PPO | $885.30 | ↑ +8% |
| Geisinger | Commercial | $891.84 | ↑ +9% |
| UPMC Health Plan | Commercial | $953.40 | ↑ +17% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +24% |
| Prime Net | FH-Medical Rental | $1,029.67 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,157.70 | ↑ +42% |
| UPMC Health Plan | CHIP | $1,299.48 | ↑ +59% |
| Cigna | Commercial | $9,539.00 | ↑ +1067% |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $817.20 | $50.02 – $1,299.48 |
| UPMC Hanover | Hanover | $817.20 | $47.05 – $1,016.56 |
| UPMC Lititz | Lititz | $817.20 | $47.05 – $1,016.56 |
| UPMC Magee | Pittsburgh | $199.80 | $40.76 – $303.94 |
| UPMC McKeesport | Mckeesport | $231.00 | $40.76 – $309.57 |
| UPMC Memorial | York | $817.20 | $38.87 – $1,016.56 |
| UPMC Mercy | Pittsburgh | $214.80 | $40.76 – $309.57 |
| UPMC Muncy | Muncy | $922.20 | $40.76 – $993.28 |