Cath combo lt&rt heart w/inj/s at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$8,719.20
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.
$14,532.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $17,298.00 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,692.28 | ↓ -81% |
| UPMC Work Partners | Workers Comp | $1,722.26 | ↓ -80% |
| Prime Net | Managed Medicare | $1,990.88 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $2,906.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,906.40 | ↓ -67% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $3,046.11 | ↓ -65% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $3,046.11 | ↓ -65% |
| Humana | Medicare | $3,076.88 | ↓ -65% |
| Aetna | Medicare | $3,209.19 | ↓ -63% |
| Cigna | Medicare | $3,230.72 | ↓ -63% |
| Geisinger | Medicare | $3,230.72 | ↓ -63% |
| United Healthcare | Medicare | $3,292.26 | ↓ -62% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,323.03 | ↓ -62% |
| UPMC Health Plan | CHIP | $4,908.51 | ↓ -44% |
| Keystone Autism Services | ACAP | $4,923.01 | ↓ -44% |
| Prime Net | Legacy Commercial | $5,667.48 | ↓ -35% |
| Prime Net | ACO | $5,711.08 | ↓ -34% |
| Aetna | ACO | $5,972.65 | ↓ -32% |
| Prime Net | NonGateKeeper | $6,757.38 | ↓ -23% |
| Prime Net | GateKeeper | $6,800.98 | ↓ -22% |
| Aetna | Commercial | $7,106.15 | ↓ -18% |
| Capital Blue Cross | Commercial | $7,949.00 | ↓ -9% |
| Keystone Health Plan | Commercial | $7,949.00 | ↓ -9% |
| Capital Blue Cross | CHIP | $7,949.00 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $7,992.60 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $7,992.60 | ↓ -8% |
| Highmark BCBS of PA | Community Blue PPO | $8,654.03 | ↓ -1% |
| Highmark BCBS of PA | CHIP - Managed Care | $9,020.18 | ↑ +3% |
| Wellspan Population Health | PPO | $9,445.80 | ↑ +8% |
| Geisinger | Commercial | $9,515.55 | ↑ +9% |
| Highmark BCBS of PA | Commercial | $9,615.56 | ↑ +10% |
| UPMC Health Plan | Commercial | $10,172.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $10,986.19 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $12,352.20 | ↑ +42% |
| Cigna | Commercial | $17,298.00 | ↑ +98% |
| 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
Comments
Cath combo lt&rt heart w/inj/s at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $9,891.60 | $1,368.34 – $13,188.80 |
| UPMC Community Osteopathic | Harrisburg | $8,719.20 | $1,016.56 – $12,352.20 |
| UPMC Hamot | Erie | $14,842.20 | $1,368.34 – $4,459.95 |
| UPMC Hanover | Hanover | $8,719.20 | $1,016.56 – $4,916.22 |
| UPMC Jameson | New Castle | $8,231.40 | $892.40 – $3,833.07 |
| UPMC Lititz | Lititz | $8,719.20 | $1,016.56 – $4,942.77 |
| UPMC McKeesport | Mckeesport | $13,462.80 | $1,381.37 – $3,373.11 |
| UPMC Memorial | York | $8,719.20 | $1,016.56 – $4,934.75 |