Cath segmntl pulm art at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$4,567.80
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.
$7,613.00
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.
$145.41 with Highmark Wholecare (prev Gateway) vs $9,539.00 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 | $145.41 | ↓ -97% |
| UPMC Health Plan | Managed Medicaid | $148.85 | ↓ -97% |
| United Healthcare Community Plan for Families | PA Medicaid | $150.00 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $154.57 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $155.95 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $166.78 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $195.13 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $575.25 | ↓ -87% |
| Prime Net | Managed Medicare | $1,042.98 | ↓ -77% |
| Aetna | Medicare | $1,256.14 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $1,522.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,522.60 | ↓ -67% |
| UPMC Health Plan | CHIP | $1,714.38 | ↓ -62% |
| Prime Net | Legacy Commercial | $2,969.07 | ↓ -35% |
| Aetna | ACO | $2,991.91 | ↓ -34% |
| Prime Net | ACO | $2,991.91 | ↓ -34% |
| Prime Net | NonGateKeeper | $3,540.05 | ↓ -22% |
| Aetna | Commercial | $3,562.88 | ↓ -22% |
| Prime Net | GateKeeper | $3,562.88 | ↓ -22% |
| Keystone Health Plan | Commercial | $4,164.31 | ↓ -9% |
| Capital Blue Cross | Commercial | $4,164.31 | ↓ -9% |
| Capital Blue Cross | CHIP | $4,164.31 | ↓ -9% |
| Wellspan Population Health | PPO | $4,948.45 | ↑ +8% |
| Geisinger | Commercial | $4,984.99 | ↑ +9% |
| UPMC Health Plan | Commercial | $5,329.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $5,755.43 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $6,471.05 | ↑ +42% |
| Cigna | Commercial | $9,539.00 | ↑ +109% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Cath segmntl pulm art at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,180.80 | $114.50 – $1,574.40 |
| UPMC Community Osteopathic | Harrisburg | $4,567.80 | $150.00 – $6,471.05 |
| UPMC Hamot | Erie | $2,312.40 | $125.95 – $589.56 |
| UPMC Hanover | Hanover | $4,567.80 | $145.41 – $582.15 |
| UPMC Lititz | Lititz | $4,567.80 | $145.41 – $575.25 |
| UPMC Magee | Pittsburgh | $2,680.20 | $125.95 – $589.56 |
| UPMC Memorial | York | $4,567.80 | $145.41 – $582.15 |
| UPMC Mercy | Pittsburgh | $2,311.80 | $125.95 – $597.66 |