Bundled special stain group 2 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$78.60
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.
$131.00
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.
$17.95 with Prime Net vs $385.36 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $17.95 | ↓ -77% |
| UPMC Health Plan | CHIP | $23.46 | ↓ -70% |
| Capital Blue Cross | Medicare Advantage | $26.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $26.20 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $43.37 | ↓ -45% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $51.01 | ↓ -35% |
| Prime Net | Legacy Commercial | $51.09 | ↓ -35% |
| Aetna | ACO | $51.48 | ↓ -35% |
| Prime Net | ACO | $51.48 | ↓ -35% |
| United Healthcare Community Plan for Families | PA Medicaid | $53.97 | ↓ -31% |
| Prime Net | NonGateKeeper | $60.91 | ↓ -23% |
| Prime Net | GateKeeper | $61.31 | ↓ -22% |
| Aetna | Commercial | $61.31 | ↓ -22% |
| Highmark Wholecare (prev Gateway) | Medicaid | $64.78 | ↓ -18% |
| UPMC Health Plan | Managed Medicaid | $66.31 | ↓ -16% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $69.48 | ↓ -12% |
| Capital Blue Cross | Commercial | $71.66 | ↓ -9% |
| Capital Blue Cross | CHIP | $71.66 | ↓ -9% |
| Keystone Health Plan | Commercial | $71.66 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $74.30 | ↓ -5% |
| Wellspan Population Health | PPO | $85.15 | ↑ +8% |
| Geisinger | Commercial | $85.78 | ↑ +9% |
| PA Health & Wellness | PA Medicaid HMO | $86.93 | ↑ +11% |
| UPMC Health Plan | Commercial | $91.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $99.04 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $111.35 | ↑ +42% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $122.08 | ↑ +55% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $122.08 | ↑ +55% |
| Humana | Medicare | $123.31 | ↑ +57% |
| Aetna | Medicare | $128.61 | ↑ +64% |
| Geisinger | Medicare | $129.48 | ↑ +65% |
| Cigna | Medicare | $129.48 | ↑ +65% |
| United Healthcare | Medicare | $131.94 | ↑ +68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $133.17 | ↑ +69% |
| Cigna | Commercial | $167.96 | ↑ +114% |
| Keystone Autism Services | ACAP | $197.30 | ↑ +151% |
| Highmark BCBS of PA | Community Blue PPO | $346.82 | ↑ +341% |
| Highmark BCBS of PA | CHIP - Managed Care | $361.50 | ↑ +360% |
| Highmark BCBS of PA | Commercial | $385.36 | ↑ +390% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Bundled special stain group 2 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $139.20 | $6.25 – $185.60 |
| UPMC Bedford | Everett | $49.80 | $6.54 – $86.93 |
| UPMC Cole | Coudersport | $180.60 | $23.46 – $240.80 |
| UPMC Community Osteopathic | Harrisburg | $78.60 | $13.60 – $135.68 |
| UPMC East | Monroeville | $48.00 | $6.31 – $129.03 |
| UPMC Hamot | Erie | $147.60 | $6.25 – $153.18 |
| UPMC Northwest | Seneca | $67.20 | $6.51 – $129.03 |
| UPMC Hanover | Hanover | $78.60 | $23.46 – $197.02 |