Blind interatrial shunt ide at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$39,788.40
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.
$66,314.00
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.
$9,085.02 with Prime Net vs $56,366.90 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $9,085.02 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $9,207.73 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $13,262.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $13,262.80 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $13,984.66 | ↓ -65% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $16,573.92 | ↓ -58% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $16,573.92 | ↓ -58% |
| Humana | Medicare | $16,741.33 | ↓ -58% |
| Cigna | Commercial | $17,298.00 | ↓ -57% |
| Aetna | Medicare | $17,461.21 | ↓ -56% |
| Geisinger | Medicare | $17,578.40 | ↓ -56% |
| Cigna | Medicare | $17,578.40 | ↓ -56% |
| United Healthcare | Medicare | $17,913.22 | ↓ -55% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18,080.64 | ↓ -55% |
| Prime Net | Legacy Commercial | $25,862.46 | ↓ -35% |
| Prime Net | ACO | $26,061.40 | ↓ -35% |
| Keystone Autism Services | ACAP | $26,786.13 | ↓ -33% |
| Aetna | ACO | $27,255.05 | ↓ -32% |
| Prime Net | NonGateKeeper | $30,836.01 | ↓ -23% |
| Prime Net | GateKeeper | $31,034.95 | ↓ -22% |
| Aetna | Commercial | $32,427.55 | ↓ -18% |
| Keystone Health Plan | Commercial | $36,273.76 | ↓ -9% |
| Capital Blue Cross | CHIP | $36,273.76 | ↓ -9% |
| Capital Blue Cross | Commercial | $36,273.76 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $36,472.70 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $36,472.70 | ↓ -8% |
| Wellspan Population Health | PPO | $43,104.10 | ↑ +8% |
| Geisinger | Commercial | $43,422.41 | ↑ +9% |
| UPMC Health Plan | Commercial | $46,419.80 | ↑ +17% |
| UPMC Health Plan | CHIP | $46,419.80 | ↑ +17% |
| Highmark BCBS of PA | Community Blue PPO | $47,086.66 | ↑ +18% |
| Highmark BCBS of PA | CHIP - Managed Care | $49,078.88 | ↑ +23% |
| Prime Net | FH-Medical Rental | $50,133.38 | ↑ +26% |
| Highmark BCBS of PA | Commercial | $52,318.33 | ↑ +31% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $56,366.90 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Blind interatrial shunt ide at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $39,788.40 | $9,415.00 – $56,366.90 |
| UPMC Hanover | Hanover | $39,788.40 | $13,984.66 – $26,749.17 |
| UPMC Lititz | Lititz | $39,788.40 | $13,984.66 – $26,893.65 |
| UPMC Memorial | York | $39,788.40 | $5,703.43 – $26,849.97 |
| UPMC Somerset | Somerset | $39,788.40 | $6,926.94 – $18,017.73 |