Aspirate/inj ganglion cyst 20612 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$401.40
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.
$669.00
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.
$49.36 with AmeriHealth Caritas vs $1,368.75 with UPMC Health Plan — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $49.36 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $49.36 | ↓ -88% |
| UPMC Health Plan | Managed Medicaid | $50.53 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $52.94 | ↓ -87% |
| Geisinger | Medicaid/CHIP | $56.62 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $66.24 | ↓ -83% |
| Prime Net | Managed Medicare | $91.65 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $108.60 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $133.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $133.80 | ↓ -67% |
| Prime Net | Legacy Commercial | $260.91 | ↓ -35% |
| Prime Net | ACO | $262.92 | ↓ -34% |
| Aetna | ACO | $262.92 | ↓ -34% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $279.56 | ↓ -30% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $279.56 | ↓ -30% |
| Humana | Medicare | $282.38 | ↓ -30% |
| Aetna | Medicare | $294.52 | ↓ -27% |
| Cigna | Medicare | $296.50 | ↓ -26% |
| Geisinger | Medicare | $296.50 | ↓ -26% |
| United Healthcare | Medicare | $302.15 | ↓ -25% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $304.97 | ↓ -24% |
| Prime Net | NonGateKeeper | $311.08 | ↓ -23% |
| Prime Net | GateKeeper | $313.09 | ↓ -22% |
| Aetna | Commercial | $313.09 | ↓ -22% |
| Keystone Health Plan | Commercial | $365.94 | ↓ -9% |
| Capital Blue Cross | CHIP | $365.94 | ↓ -9% |
| Capital Blue Cross | Commercial | $365.94 | ↓ -9% |
| Wellspan Population Health | PPO | $434.85 | ↑ +8% |
| Geisinger | Commercial | $438.06 | ↑ +9% |
| Keystone Autism Services | ACAP | $451.81 | ↑ +13% |
| UPMC Health Plan | Commercial | $468.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $505.76 | ↑ +26% |
| Cigna | Commercial | $521.82 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $568.65 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $794.22 | ↑ +98% |
| Highmark BCBS of PA | CHIP - Managed Care | $827.83 | ↑ +106% |
| Highmark BCBS of PA | Commercial | $882.47 | ↑ +120% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +153% |
| UPMC Health Plan | CHIP | $1,368.75 | ↑ +241% |
| 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
Aspirate/inj ganglion cyst 20612 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $640.80 | $40.81 – $961.20 |
| UPMC Cole | Coudersport | $215.40 | $14.14 – $103.78 |
| UPMC Community Osteopathic | Harrisburg | $401.40 | $49.36 – $1,368.75 |
| UPMC Hanover | Hanover | $401.40 | $49.36 – $1,016.56 |
| UPMC Horizon-Greenville | Greenville | $449.40 | $42.76 – $303.94 |
| UPMC Kane | Kane | $238.80 | $42.76 – $268.46 |
| UPMC Lititz | Lititz | $401.40 | $49.36 – $1,016.56 |
| UPMC Magee | Pittsburgh | $474.60 | $42.76 – $303.94 |