Bronchoscopy w/biopsy(s) 31625 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2,168.40
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.
$3,614.00
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.
$200.42 with Highmark Wholecare (prev Gateway) vs $5,155.35 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $200.42 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $205.15 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $213.04 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $214.94 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $229.87 | ↓ -89% |
| PA Health & Wellness | PA Medicaid HMO | $268.94 | ↓ -88% |
| Prime Net | Managed Medicare | $495.12 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $663.95 | ↓ -69% |
| Capital Blue Cross | Medicare Advantage | $722.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $722.80 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $869.84 | ↓ -60% |
| Prime Net | Legacy Commercial | $1,409.46 | ↓ -35% |
| Prime Net | ACO | $1,420.30 | ↓ -35% |
| Aetna | ACO | $1,420.30 | ↓ -35% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,633.16 | ↓ -25% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,633.16 | ↓ -25% |
| Humana | Medicare | $1,649.66 | ↓ -24% |
| Prime Net | NonGateKeeper | $1,680.51 | ↓ -23% |
| Prime Net | GateKeeper | $1,691.35 | ↓ -22% |
| Aetna | Commercial | $1,691.35 | ↓ -22% |
| Aetna | Medicare | $1,720.60 | ↓ -21% |
| Cigna | Medicare | $1,732.14 | ↓ -20% |
| Geisinger | Medicare | $1,732.14 | ↓ -20% |
| United Healthcare | Medicare | $1,765.14 | ↓ -19% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,781.63 | ↓ -18% |
| Keystone Health Plan | Commercial | $1,976.86 | ↓ -9% |
| Capital Blue Cross | CHIP | $1,976.86 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,976.86 | ↓ -9% |
| UPMC Health Plan | CHIP | $2,298.41 | ↑ +6% |
| Wellspan Population Health | PPO | $2,349.10 | ↑ +8% |
| Geisinger | Commercial | $2,366.45 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,529.80 | ↑ +17% |
| Keystone Autism Services | ACAP | $2,639.46 | ↑ +22% |
| Prime Net | FH-Medical Rental | $2,732.18 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,071.90 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $4,639.83 | ↑ +114% |
| Highmark BCBS of PA | CHIP - Managed Care | $4,836.14 | ↑ +123% |
| Cigna | Commercial | $5,035.00 | ↑ +132% |
| Highmark BCBS of PA | Commercial | $5,155.35 | ↑ +138% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Bronchoscopy w/biopsy(s) 31625 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,314.60 | $157.81 – $1,752.80 |
| UPMC Bedford | Everett | $4,300.20 | $165.70 – $6,450.30 |
| UPMC Community Osteopathic | Harrisburg | $2,168.40 | $213.04 – $3,071.90 |
| UPMC Hamot | Erie | $3,372.60 | $173.59 – $2,391.19 |
| UPMC Northwest | Seneca | $2,132.40 | $173.59 – $1,726.28 |
| UPMC Hanover | Hanover | $2,168.40 | $200.42 – $2,635.82 |
| UPMC Jameson | New Castle | $3,445.20 | $173.59 – $2,219.51 |
| UPMC Lititz | Lititz | $2,168.40 | $200.42 – $2,650.05 |