Cardiac MRI w/stress img at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$3,422.40
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.
$5,704.00
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.
$329.52 with United Healthcare Community Plan for Families vs $4,848.40 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $329.52 | ↓ -90% |
| Premier Comp Solutions | Worker's Comp | $425.00 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $468.62 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $468.62 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $479.69 | ↓ -86% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $502.56 | ↓ -85% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $519.26 | ↓ -85% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $519.26 | ↓ -85% |
| Humana | Medicare | $524.51 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $537.47 | ↓ -84% |
| Aetna | Medicare | $547.06 | ↓ -84% |
| Cigna | Medicare | $550.74 | ↓ -84% |
| Geisinger | Medicare | $550.74 | ↓ -84% |
| United Healthcare | Medicare | $561.23 | ↓ -84% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $566.47 | ↓ -83% |
| PA Health & Wellness | PA Medicaid HMO | $628.83 | ↓ -82% |
| Prime Net | Managed Medicare | $781.45 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $783.03 | ↓ -77% |
| Keystone Autism Services | ACAP | $839.22 | ↓ -75% |
| Capital Blue Cross | Medicare Advantage | $1,140.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,140.80 | ↓ -67% |
| Highmark BCBS of PA | Community Blue PPO | $1,475.24 | ↓ -57% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,537.65 | ↓ -55% |
| Highmark BCBS of PA | Commercial | $1,639.15 | ↓ -52% |
| Prime Net | Legacy Commercial | $2,224.56 | ↓ -35% |
| Aetna | ACO | $2,241.67 | ↓ -35% |
| Prime Net | ACO | $2,241.67 | ↓ -35% |
| Cigna | Commercial | $2,530.96 | ↓ -26% |
| Prime Net | NonGateKeeper | $2,652.36 | ↓ -23% |
| Aetna | Commercial | $2,669.47 | ↓ -22% |
| Prime Net | GateKeeper | $2,669.47 | ↓ -22% |
| Keystone Health Plan | Commercial | $3,120.09 | ↓ -9% |
| Capital Blue Cross | CHIP | $3,120.09 | ↓ -9% |
| Capital Blue Cross | Commercial | $3,120.09 | ↓ -9% |
| Wellspan Population Health | PPO | $3,707.60 | ↑ +8% |
| Geisinger | Commercial | $3,734.98 | ↑ +9% |
| UPMC Health Plan | Commercial | $3,992.80 | ↑ +17% |
| UPMC Health Plan | CHIP | $3,992.80 | ↑ +17% |
| United Healthcare | Commercial | $4,198.14 | ↑ +23% |
| Prime Net | FH-Medical Rental | $4,312.22 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,848.40 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Cardiac MRI w/stress img at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,597.60 | $251.54 – $4,796.80 |
| UPMC Community Osteopathic | Harrisburg | $3,422.40 | $329.52 – $4,848.40 |
| UPMC Hamot | Erie | $3,379.20 | $405.89 – $748.23 |
| UPMC Hanover | Hanover | $3,422.40 | $329.52 – $838.06 |
| UPMC Lititz | Lititz | $3,422.40 | $329.52 – $842.59 |
| UPMC Memorial | York | $3,422.40 | $329.52 – $2,123.51 |
| UPMC Muncy | Muncy | $2,657.40 | $321.97 – $800.43 |
| UPMC Passavant-McCandless | Pittsburgh | $1,190.40 | $405.89 – $870.03 |