Bx vulva or perineum/1 lesion 56605 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
not published by hospital
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.
not published by hospital
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.
$70.50 with Highmark Wholecare (prev Gateway) vs $3,397.00 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $70.50 | — |
| UPMC Health Plan | Managed Medicaid | $72.16 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $74.94 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $75.60 | — |
| Geisinger | Medicaid/CHIP | $80.86 | — |
| PA Health & Wellness | PA Medicaid HMO | $94.60 | — |
| UPMC Work Partners | Workers Comp | $226.26 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $824.64 | — |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $824.64 | — |
| Humana | Medicare | $832.97 | — |
| Aetna | Medicare | $868.79 | — |
| Cigna | Medicare | $874.62 | — |
| Geisinger | Medicare | $874.62 | — |
| United Healthcare | Medicare | $891.28 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $899.61 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | — |
| Keystone Autism Services | ACAP | $1,332.75 | — |
| UPMC Health Plan | CHIP | $1,731.69 | — |
| Highmark BCBS of PA | Community Blue PPO | $2,342.81 | — |
| Highmark BCBS of PA | CHIP - Managed Care | $2,441.93 | — |
| Highmark BCBS of PA | Commercial | $2,603.11 | — |
| Cigna | Commercial | $3,397.00 | — |
| 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
Comments
Bx vulva or perineum/1 lesion 56605 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $1,452.00 | $70.50 – $2,057.00 |
| UPMC Hamot | Erie | $3,131.40 | $61.06 – $1,203.71 |
| UPMC Hanover | Hanover | $1,452.00 | $70.50 – $1,330.91 |
| UPMC Kane | Kane | $414.00 | $61.06 – $407.17 |
| UPMC Magee | Pittsburgh | $1,717.20 | $61.06 – $896.56 |
| UPMC Memorial | York | $1,452.00 | $70.50 – $1,335.92 |
| UPMC Passavant-McCandless | Pittsburgh | $3,544.20 | $61.06 – $913.16 |
| UPMC Presbyterian | Pittsburgh | $3,063.60 | $61.06 – $931.20 |