Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2,304.60
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.
$3,841.00
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.
$75.92 with Highmark Wholecare (prev Gateway) vs $3,397.00 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 | $75.92 | ↓ -97% |
| UPMC Health Plan | Managed Medicaid | $77.71 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $80.70 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $81.42 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $87.08 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $101.88 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $158.46 | ↓ -93% |
| Prime Net | Managed Medicare | $526.22 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $666.34 | ↓ -71% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $666.34 | ↓ -71% |
| Humana | Medicare | $673.07 | ↓ -71% |
| Aetna | Medicare | $702.01 | ↓ -70% |
| Cigna | Medicare | $706.72 | ↓ -69% |
| Geisinger | Medicare | $706.72 | ↓ -69% |
| United Healthcare | Medicare | $720.18 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $726.92 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $768.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $768.20 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -56% |
| Keystone Autism Services | ACAP | $1,076.91 | ↓ -53% |
| Prime Net | Legacy Commercial | $1,497.99 | ↓ -35% |
| Prime Net | ACO | $1,509.51 | ↓ -35% |
| Aetna | ACO | $1,509.51 | ↓ -35% |
| Prime Net | NonGateKeeper | $1,786.07 | ↓ -22% |
| Aetna | Commercial | $1,797.59 | ↓ -22% |
| Prime Net | GateKeeper | $1,797.59 | ↓ -22% |
| Highmark BCBS of PA | Community Blue PPO | $1,893.08 | ↓ -18% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,973.17 | ↓ -14% |
| UPMC Health Plan | CHIP | $2,036.33 | ↓ -12% |
| Capital Blue Cross | Commercial | $2,101.03 | ↓ -9% |
| Capital Blue Cross | CHIP | $2,101.03 | ↓ -9% |
| Keystone Health Plan | Commercial | $2,101.03 | ↓ -9% |
| Highmark BCBS of PA | Commercial | $2,103.41 | ↓ -9% |
| Wellspan Population Health | PPO | $2,496.65 | ↑ +8% |
| Geisinger | Commercial | $2,515.09 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,688.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,903.80 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,264.85 | ↑ +42% |
| Cigna | Commercial | $3,397.00 | ↑ +47% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $559.20 | $59.78 – $745.60 |
| UPMC Bedford | Everett | $1,597.80 | $62.77 – $2,396.70 |
| UPMC Cole | Coudersport | $112.20 | $51.84 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $2,304.60 | $80.70 – $3,264.85 |
| UPMC East | Monroeville | $570.60 | $65.76 – $760.80 |
| UPMC Hamot | Erie | $543.60 | $65.76 – $975.61 |
| UPMC Northwest | Seneca | $777.00 | $65.76 – $704.33 |
| UPMC Hanover | Hanover | $2,304.60 | $75.92 – $1,075.42 |