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Cataract Surgery 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.
$765.21 with Highmark Wholecare (prev Gateway) vs $9,812.00 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 | $765.21 | — |
| UPMC Health Plan | Managed Medicaid | $783.29 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $813.42 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $820.65 | — |
| Geisinger | Medicaid/CHIP | $877.65 | — |
| PA Health & Wellness | PA Medicaid HMO | $1,026.83 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $2,159.97 | — |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $2,159.97 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $2,166.74 | — |
| Humana | Medicare | $2,181.79 | — |
| Aetna | Medicare | $2,275.61 | — |
| Cigna | Medicare | $2,290.88 | — |
| Geisinger | Medicare | $2,290.88 | — |
| United Healthcare | Medicare | $2,334.52 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,356.33 | — |
| UPMC Work Partners | Workers Comp | $3,066.48 | — |
| Keystone Autism Services | ACAP | $3,490.86 | — |
| UPMC Health Plan | CHIP | $5,156.09 | — |
| Highmark BCBS of PA | Community Blue PPO | $6,136.50 | — |
| Highmark BCBS of PA | CHIP - Managed Care | $6,396.14 | — |
| Highmark BCBS of PA | Commercial | $6,818.31 | — |
| Cigna | Commercial | $9,812.00 | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Cataract Surgery at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | not published | $662.78 – $3,123.38 |
| UPMC Altoona | Altoona | not published | $602.53 – $2,930.19 |
| UPMC Bedford | Everett | not published | $632.66 – $2,930.19 |
| UPMC Magee | Pittsburgh | not published | $662.78 – $3,123.38 |
| UPMC McKeesport | Mckeesport | not published | $662.78 – $3,123.38 |
| UPMC Memorial | York | not published | $765.21 – $3,499.18 |
| UPMC Mercy | Pittsburgh | not published | $662.78 – $3,170.46 |
| UPMC Northwest | Seneca | not published | $662.78 – $2,938.64 |