Cell function assay w/stim at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$490.20
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.
$817.00
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.
$12.47 with United Healthcare vs $694.45 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 | Commercial | $12.47 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $77.84 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicaid | $98.86 | ↓ -80% |
| UPMC Health Plan | Managed Medicaid | $101.19 | ↓ -79% |
| United Healthcare Community Plan for Families | PA Medicaid | $101.97 | ↓ -79% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $106.02 | ↓ -78% |
| Prime Net | Managed Medicare | $111.93 | ↓ -77% |
| Geisinger | Medicaid/CHIP | $113.38 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $132.65 | ↓ -73% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $134.50 | ↓ -73% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $134.50 | ↓ -73% |
| Humana | Medicare | $135.86 | ↓ -72% |
| UPMC Work Partners | Workers Comp | $140.52 | ↓ -71% |
| Aetna | Medicare | $141.70 | ↓ -71% |
| Geisinger | Medicare | $142.65 | ↓ -71% |
| Cigna | Medicare | $142.65 | ↓ -71% |
| United Healthcare | Medicare | $145.37 | ↓ -70% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $146.73 | ↓ -70% |
| Capital Blue Cross | Medicare Advantage | $163.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $163.40 | ↓ -67% |
| Keystone Autism Services | ACAP | $217.38 | ↓ -56% |
| UPMC Health Plan | CHIP | $242.98 | ↓ -50% |
| Prime Net | Legacy Commercial | $318.63 | ↓ -35% |
| Prime Net | ACO | $321.08 | ↓ -35% |
| Aetna | ACO | $321.08 | ↓ -35% |
| Cigna | Commercial | $353.24 | ↓ -28% |
| Prime Net | NonGateKeeper | $379.90 | ↓ -23% |
| Highmark BCBS of PA | Community Blue PPO | $382.12 | ↓ -22% |
| Aetna | Commercial | $382.36 | ↓ -22% |
| Prime Net | GateKeeper | $382.36 | ↓ -22% |
| Highmark BCBS of PA | CHIP - Managed Care | $398.29 | ↓ -19% |
| Highmark BCBS of PA | Commercial | $424.58 | ↓ -13% |
| Capital Blue Cross | CHIP | $446.90 | ↓ -9% |
| Capital Blue Cross | Commercial | $446.90 | ↓ -9% |
| Keystone Health Plan | Commercial | $446.90 | ↓ -9% |
| Wellspan Population Health | PPO | $531.05 | ↑ +8% |
| Geisinger | Commercial | $534.97 | ↑ +9% |
| UPMC Health Plan | Commercial | $571.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $617.65 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $694.45 | ↑ +42% |
Visitor-reported prices
Comments
Cell function assay w/stim at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $898.80 | $77.84 – $1,198.40 |
| UPMC Bedford | Everett | $913.20 | $49.02 – $1,369.80 |
| UPMC Community Osteopathic | Harrisburg | $490.20 | $77.84 – $694.45 |
| UPMC East | Monroeville | $717.60 | $66.84 – $956.80 |
| UPMC Hamot | Erie | $1,008.00 | $77.84 – $180.86 |
| UPMC Northwest | Seneca | $1,146.00 | $67.46 – $142.65 |
| UPMC Hanover | Hanover | $490.20 | $12.47 – $217.38 |
| UPMC Horizon-Greenville | Greenville | $721.80 | $67.68 – $254.94 |