Bx skin incisnl ea sep/add l les at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$478.80
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.
$798.00
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.
$33.39 with Highmark Wholecare (prev Gateway) vs $678.30 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $33.39 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $33.39 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $34.18 | ↓ -93% |
| United Healthcare Community Plan for Families | PA Medicaid | $34.44 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $35.81 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $38.29 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $44.80 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $89.12 | ↓ -81% |
| Prime Net | Managed Medicare | $109.33 | ↓ -77% |
| UPMC Health Plan | CHIP | $128.97 | ↓ -73% |
| Aetna | Medicare | $131.67 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $159.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $159.60 | ↓ -67% |
| Prime Net | Legacy Commercial | $311.22 | ↓ -35% |
| Prime Net | ACO | $313.61 | ↓ -35% |
| Aetna | ACO | $313.61 | ↓ -35% |
| Prime Net | NonGateKeeper | $371.07 | ↓ -23% |
| Prime Net | GateKeeper | $373.46 | ↓ -22% |
| Aetna | Commercial | $373.46 | ↓ -22% |
| Keystone Health Plan | Commercial | $436.51 | ↓ -9% |
| Capital Blue Cross | Commercial | $436.51 | ↓ -9% |
| Capital Blue Cross | CHIP | $436.51 | ↓ -9% |
| Wellspan Population Health | PPO | $518.70 | ↑ +8% |
| Geisinger | Commercial | $522.53 | ↑ +9% |
| UPMC Health Plan | Commercial | $558.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $603.29 | ↑ +26% |
| Cigna | Commercial | $622.44 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $678.30 | ↑ +42% |
Visitor-reported prices
Comments
Bx skin incisnl ea sep/add l les at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $644.40 | $26.29 – $859.20 |
| UPMC Cole | Coudersport | $46.80 | $21.62 – $2,325.85 |
| UPMC Hanover | Hanover | $478.80 | $33.39 – $89.12 |
| UPMC Lititz | Lititz | $478.80 | $26.92 – $89.12 |
| UPMC Magee | Pittsburgh | $666.00 | $28.92 – $85.16 |
| UPMC Mercy | Pittsburgh | $706.20 | $28.92 – $95.35 |
| UPMC Passavant-McCandless | Pittsburgh | $666.00 | $28.92 – $99.02 |
| UPMC Presbyterian | Pittsburgh | $832.80 | $28.92 – $110.87 |