Biliary endoscopy thru skin at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$11,428.80
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.
$19,048.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $31,124.68 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $1,297.61 | ↓ -89% |
| Prime Net | Managed Medicare | $2,609.58 | ↓ -77% |
| UPMC Health Plan | CHIP | $2,636.98 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $3,809.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $3,809.60 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $5,477.77 | ↓ -52% |
| Cigna | Commercial | $6,413.00 | ↓ -44% |
| Prime Net | Legacy Commercial | $7,428.72 | ↓ -35% |
| Prime Net | ACO | $7,485.86 | ↓ -35% |
| Aetna | ACO | $7,485.86 | ↓ -35% |
| Prime Net | NonGateKeeper | $8,857.32 | ↓ -23% |
| Prime Net | GateKeeper | $8,914.46 | ↓ -22% |
| Aetna | Commercial | $8,914.46 | ↓ -22% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $9,859.98 | ↓ -14% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $9,859.98 | ↓ -14% |
| Humana | Medicare | $9,959.58 | ↓ -13% |
| Aetna | Medicare | $10,387.84 | ↓ -9% |
| Keystone Health Plan | Commercial | $10,419.26 | ↓ -9% |
| Capital Blue Cross | CHIP | $10,419.26 | ↓ -9% |
| Capital Blue Cross | Commercial | $10,419.26 | ↓ -9% |
| Cigna | Medicare | $10,457.56 | ↓ -8% |
| Geisinger | Medicare | $10,457.56 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $10,476.40 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $10,476.40 | ↓ -8% |
| United Healthcare | Medicare | $10,656.75 | ↓ -7% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10,756.35 | ↓ -6% |
| Wellspan Population Health | PPO | $12,381.20 | ↑ +8% |
| Geisinger | Commercial | $12,472.63 | ↑ +9% |
| UPMC Health Plan | Commercial | $13,333.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $14,400.29 | ↑ +26% |
| Keystone Autism Services | ACAP | $15,935.33 | ↑ +39% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $16,190.80 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $28,012.31 | ↑ +145% |
| Highmark BCBS of PA | CHIP - Managed Care | $29,197.50 | ↑ +155% |
| Highmark BCBS of PA | Commercial | $31,124.68 | ↑ +172% |
| 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
Comments
Biliary endoscopy thru skin at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $11,428.80 | $1,016.56 – $16,190.80 |
| UPMC Hamot | Erie | $4,809.60 | $836.96 – $12,372.12 |
| UPMC Hanover | Hanover | $11,428.80 | $1,016.56 – $15,913.34 |
| UPMC Lititz | Lititz | $11,428.80 | $1,016.56 – $15,999.30 |
| UPMC Memorial | York | $11,428.80 | $682.16 – $15,973.31 |
| UPMC Somerset | Somerset | $11,428.80 | $828.50 – $10,718.93 |