Bone survey-lead poisoning at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$262.80
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.
$438.00
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.
$39.59 with United Healthcare Community Plan for Families vs $589.04 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $39.59 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $59.61 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $59.61 | ↓ -77% |
| Prime Net | Managed Medicare | $60.01 | ↓ -77% |
| UPMC Health Plan | Managed Medicaid | $61.02 | ↓ -77% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $63.93 | ↓ -76% |
| Geisinger | Medicaid/CHIP | $68.37 | ↓ -74% |
| PA Health & Wellness | PA Medicaid HMO | $80.00 | ↓ -70% |
| Capital Blue Cross | Medicare Advantage | $87.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $87.60 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $97.78 | ↓ -63% |
| Premier Comp Solutions | Worker's Comp | $97.78 | ↓ -63% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $100.71 | ↓ -62% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $100.71 | ↓ -62% |
| Humana | Medicare | $101.73 | ↓ -61% |
| Aetna | Medicare | $106.10 | ↓ -60% |
| Geisinger | Medicare | $106.82 | ↓ -59% |
| Cigna | Medicare | $106.82 | ↓ -59% |
| United Healthcare | Medicare | $108.85 | ↓ -59% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $109.87 | ↓ -58% |
| Keystone Autism Services | ACAP | $162.77 | ↓ -38% |
| Prime Net | Legacy Commercial | $170.82 | ↓ -35% |
| Prime Net | ACO | $172.13 | ↓ -35% |
| Aetna | ACO | $172.13 | ↓ -35% |
| UPMC Health Plan | CHIP | $199.53 | ↓ -24% |
| Prime Net | NonGateKeeper | $203.67 | ↓ -23% |
| Aetna | Commercial | $204.98 | ↓ -22% |
| Prime Net | GateKeeper | $204.98 | ↓ -22% |
| Capital Blue Cross | CHIP | $239.59 | ↓ -9% |
| Keystone Health Plan | Commercial | $239.59 | ↓ -9% |
| Capital Blue Cross | Commercial | $239.59 | ↓ -9% |
| Wellspan Population Health | PPO | $284.70 | ↑ +8% |
| Highmark BCBS of PA | Community Blue PPO | $286.13 | ↑ +9% |
| Geisinger | Commercial | $286.80 | ↑ +9% |
| Highmark BCBS of PA | CHIP - Managed Care | $298.23 | ↑ +13% |
| UPMC Health Plan | Commercial | $306.60 | ↑ +17% |
| Highmark BCBS of PA | Commercial | $317.92 | ↑ +21% |
| United Healthcare | Commercial | $322.37 | ↑ +23% |
| Prime Net | FH-Medical Rental | $331.13 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $372.30 | ↑ +42% |
| Cigna | Commercial | $589.04 | ↑ +124% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Bone survey-lead poisoning at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $462.60 | $36.58 – $693.90 |
| UPMC Cole | Coudersport | $301.20 | $49.29 – $401.60 |
| UPMC Community Osteopathic | Harrisburg | $262.80 | $39.59 – $372.30 |
| UPMC Hamot | Erie | $680.40 | $51.63 – $166.40 |
| UPMC Northwest | Seneca | $420.60 | $51.63 – $106.45 |
| UPMC Hanover | Hanover | $262.80 | $39.59 – $162.54 |
| UPMC Horizon-Greenville | Greenville | $346.20 | $51.63 – $136.62 |
| UPMC Jameson | New Castle | $265.80 | $34.75 – $126.72 |