Assay of prostaglandin at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$211.80
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.
$353.00
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.
$11.00 with AmeriHealth Caritas vs $300.05 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $11.00 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $13.97 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $14.30 | ↓ -93% |
| United Healthcare Community Plan for Families | PA Medicaid | $14.41 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $14.98 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $16.02 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $18.75 | ↓ -91% |
| United Healthcare | Commercial | $28.70 | ↓ -86% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $41.35 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $41.35 | ↓ -80% |
| Humana | Medicare | $41.77 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $43.20 | ↓ -80% |
| Aetna | Medicare | $43.57 | ↓ -79% |
| Geisinger | Medicare | $43.86 | ↓ -79% |
| Cigna | Medicare | $43.86 | ↓ -79% |
| United Healthcare | Medicare | $44.69 | ↓ -79% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $45.11 | ↓ -79% |
| Prime Net | Managed Medicare | $48.36 | ↓ -77% |
| Keystone Autism Services | ACAP | $66.83 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $70.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $70.60 | ↓ -67% |
| Cigna | Commercial | $108.60 | ↓ -49% |
| Highmark BCBS of PA | Community Blue PPO | $117.48 | ↓ -45% |
| Highmark BCBS of PA | CHIP - Managed Care | $122.45 | ↓ -42% |
| Highmark BCBS of PA | Commercial | $130.54 | ↓ -38% |
| Prime Net | Legacy Commercial | $137.67 | ↓ -35% |
| Aetna | ACO | $138.73 | ↓ -34% |
| Prime Net | ACO | $138.73 | ↓ -34% |
| UPMC Health Plan | CHIP | $143.42 | ↓ -32% |
| Prime Net | NonGateKeeper | $164.15 | ↓ -22% |
| Aetna | Commercial | $165.20 | ↓ -22% |
| Prime Net | GateKeeper | $165.20 | ↓ -22% |
| Capital Blue Cross | Commercial | $193.09 | ↓ -9% |
| Capital Blue Cross | CHIP | $193.09 | ↓ -9% |
| Keystone Health Plan | Commercial | $193.09 | ↓ -9% |
| Wellspan Population Health | PPO | $229.45 | ↑ +8% |
| Geisinger | Commercial | $231.14 | ↑ +9% |
| UPMC Health Plan | Commercial | $247.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $266.87 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $300.05 | ↑ +42% |
Visitor-reported prices
Comments
Assay of prostaglandin at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $183.60 | $11.00 – $244.80 |
| UPMC Bedford | Everett | $336.00 | $11.00 – $504.00 |
| UPMC Community Osteopathic | Harrisburg | $211.80 | $11.00 – $300.05 |
| UPMC East | Monroeville | $186.60 | $11.00 – $248.80 |
| UPMC Hamot | Erie | $260.40 | $11.00 – $46.79 |
| UPMC Northwest | Seneca | $298.20 | $12.10 – $43.86 |
| UPMC Hanover | Hanover | $211.80 | $11.00 – $66.83 |
| UPMC Horizon-Greenville | Greenville | $843.60 | $11.00 – $75.65 |