C-1 esterase, berinert at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2,302.20
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.
$3,837.00
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.
$75.10 with Highmark BCBS of PA vs $3,261.45 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 BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $75.10 | ↓ -97% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $75.10 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $75.86 | ↓ -97% |
| Humana | Medicare | $75.86 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $75.86 | ↓ -97% |
| PA Health & Wellness | PA Medicaid HMO | $75.86 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $77.38 | ↓ -97% |
| Aetna | Medicare | $79.12 | ↓ -97% |
| Geisinger | Medicare | $79.65 | ↓ -97% |
| Cigna | Medicare | $79.65 | ↓ -97% |
| United Healthcare | Medicare | $81.17 | ↓ -96% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $81.93 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $83.44 | ↓ -96% |
| Cigna | Commercial | $90.75 | ↓ -96% |
| UPMC Health Plan | CHIP | $93.31 | ↓ -96% |
| Keystone Autism Services | ACAP | $121.38 | ↓ -95% |
| Highmark BCBS of PA | Community Blue PPO | $213.36 | ↓ -91% |
| Highmark BCBS of PA | CHIP - Managed Care | $222.39 | ↓ -90% |
| Highmark BCBS of PA | Commercial | $237.07 | ↓ -90% |
| United Healthcare | Commercial | $451.96 | ↓ -80% |
| Prime Net | Managed Medicare | $525.67 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $767.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $767.40 | ↓ -67% |
| Capital Blue Cross | CHIP | $1,231.68 | ↓ -46% |
| Keystone Health Plan | Commercial | $1,231.68 | ↓ -46% |
| Capital Blue Cross | Commercial | $1,231.68 | ↓ -46% |
| Prime Net | Legacy Commercial | $1,496.43 | ↓ -35% |
| Aetna | ACO | $1,507.94 | ↓ -35% |
| Prime Net | ACO | $1,507.94 | ↓ -35% |
| UPMC Work Partners | Workers Comp | $1,562.43 | ↓ -32% |
| Prime Net | NonGateKeeper | $1,784.20 | ↓ -23% |
| Aetna | Commercial | $1,795.72 | ↓ -22% |
| Prime Net | GateKeeper | $1,795.72 | ↓ -22% |
| Wellspan Population Health | PPO | $2,494.05 | ↑ +8% |
| Geisinger | Commercial | $2,512.47 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,685.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,900.77 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,261.45 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
C-1 esterase, berinert at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $5,886.00 | $47.90 – $157.60 |
| UPMC Community Osteopathic | Harrisburg | $2,302.20 | $75.10 – $3,261.45 |
| UPMC East | Monroeville | $6,036.00 | $24.04 – $160.80 |
| UPMC Hanover | Hanover | $2,302.20 | $75.10 – $121.38 |
| UPMC Horizon-Greenville | Greenville | $6,103.20 | $47.90 – $142.35 |
| UPMC Jameson | New Castle | $6,093.60 | $47.90 – $94.83 |
| UPMC Lititz | Lititz | $2,302.20 | $75.10 – $121.38 |
| UPMC Magee | Pittsburgh | $5,694.60 | $47.90 – $81.93 |