Cdna analysis for variants at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,070.40
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.
$1,784.00
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.
$101.86 with AmeriHealth Caritas vs $1,516.40 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $101.86 | ↓ -90% |
| United Healthcare Community Plan for Families | PA Medicaid | $147.99 | ↓ -86% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $183.35 | ↓ -83% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $183.35 | ↓ -83% |
| Humana | Medicare | $185.20 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $191.56 | ↓ -82% |
| Aetna | Medicare | $193.16 | ↓ -82% |
| Geisinger | Medicare | $194.46 | ↓ -82% |
| Cigna | Medicare | $194.46 | ↓ -82% |
| United Healthcare | Medicare | $198.16 | ↓ -81% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $200.02 | ↓ -81% |
| Prime Net | Managed Medicare | $244.41 | ↓ -77% |
| Keystone Autism Services | ACAP | $296.32 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $356.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $356.80 | ↓ -67% |
| Cigna | Commercial | $481.52 | ↓ -55% |
| Highmark BCBS of PA | Community Blue PPO | $520.89 | ↓ -51% |
| Highmark BCBS of PA | CHIP - Managed Care | $542.93 | ↓ -49% |
| Highmark BCBS of PA | Commercial | $578.77 | ↓ -46% |
| Prime Net | Legacy Commercial | $695.76 | ↓ -35% |
| Prime Net | ACO | $701.11 | ↓ -35% |
| Aetna | ACO | $701.11 | ↓ -35% |
| Prime Net | NonGateKeeper | $829.56 | ↓ -23% |
| Aetna | Commercial | $834.91 | ↓ -22% |
| Prime Net | GateKeeper | $834.91 | ↓ -22% |
| Capital Blue Cross | CHIP | $975.85 | ↓ -9% |
| Keystone Health Plan | Commercial | $975.85 | ↓ -9% |
| Capital Blue Cross | Commercial | $975.85 | ↓ -9% |
| UPMC Health Plan | CHIP | $978.04 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $981.20 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $981.20 | ↓ -8% |
| Wellspan Population Health | PPO | $1,159.60 | ↑ +8% |
| Geisinger | Commercial | $1,168.16 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,248.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,348.70 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,516.40 | ↑ +42% |
Visitor-reported prices
Comments
Cdna analysis for variants at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,277.60 | $183.04 – $736.00 |
| UPMC Bedford | Everett | $2,343.60 | $66.82 – $1,841.40 |
| UPMC Cole | Coudersport | $1,117.20 | $53.00 – $1,489.60 |
| UPMC Community Osteopathic | Harrisburg | $1,070.40 | $147.99 – $1,516.40 |
| UPMC East | Monroeville | $1,916.40 | $183.04 – $814.40 |
| UPMC Hamot | Erie | $4,339.20 | $183.04 – $458.53 |
| UPMC Hanover | Hanover | $1,070.40 | $147.99 – $978.04 |
| UPMC Horizon-Greenville | Greenville | $2,882.40 | $165.81 – $347.53 |