#cf-97variants at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$3,216.00
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.
$5,360.00
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.
$445.28 with AmeriHealth Caritas vs $4,556.00 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 | $445.28 | ↓ -86% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $551.03 | ↓ -83% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $551.03 | ↓ -83% |
| Humana | Medicare | $556.60 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicaid | $565.51 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $575.68 | ↓ -82% |
| UPMC Health Plan | Managed Medicaid | $578.86 | ↓ -82% |
| Aetna | Medicare | $580.53 | ↓ -82% |
| United Healthcare Community Plan for Families | PA Medicaid | $583.32 | ↓ -82% |
| Geisinger | Medicare | $584.43 | ↓ -82% |
| Cigna | Medicare | $584.43 | ↓ -82% |
| United Healthcare | Medicare | $595.56 | ↓ -81% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $601.13 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $606.47 | ↓ -81% |
| Geisinger | Medicaid/CHIP | $648.59 | ↓ -80% |
| Prime Net | Managed Medicare | $734.32 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $758.85 | ↓ -76% |
| Keystone Autism Services | ACAP | $890.56 | ↓ -72% |
| UPMC Health Plan | CHIP | $928.48 | ↓ -71% |
| Capital Blue Cross | Medicare Advantage | $1,072.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,072.00 | ↓ -67% |
| Cigna | Commercial | $1,447.16 | ↓ -55% |
| Highmark BCBS of PA | Community Blue PPO | $1,565.49 | ↓ -51% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,631.73 | ↓ -49% |
| Highmark BCBS of PA | Commercial | $1,739.43 | ↓ -46% |
| Prime Net | Legacy Commercial | $2,090.40 | ↓ -35% |
| Prime Net | ACO | $2,106.48 | ↓ -35% |
| Aetna | ACO | $2,106.48 | ↓ -35% |
| Prime Net | NonGateKeeper | $2,492.40 | ↓ -23% |
| Aetna | Commercial | $2,508.48 | ↓ -22% |
| Prime Net | GateKeeper | $2,508.48 | ↓ -22% |
| Capital Blue Cross | Commercial | $2,931.92 | ↓ -9% |
| Capital Blue Cross | CHIP | $2,931.92 | ↓ -9% |
| Keystone Health Plan | Commercial | $2,931.92 | ↓ -9% |
| Wellspan Population Health | PPO | $3,484.00 | ↑ +8% |
| Geisinger | Commercial | $3,509.73 | ↑ +9% |
| UPMC Health Plan | Commercial | $3,752.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $4,052.16 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,556.00 | ↑ +42% |
Visitor-reported prices
Comments
#cf-97variants at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,325.80 | $445.28 – $964.00 |
| UPMC Bedford | Everett | $3,357.60 | $200.82 – $1,095.30 |
| UPMC Cole | Coudersport | $1,763.40 | $53.00 – $2,351.20 |
| UPMC Community Osteopathic | Harrisburg | $3,216.00 | $445.28 – $4,556.00 |
| UPMC East | Monroeville | $3,357.60 | $255.41 – $973.60 |
| UPMC Hamot | Erie | $3,409.20 | $445.28 – $767.09 |
| UPMC Northwest | Seneca | $3,357.60 | $257.79 – $601.13 |
| UPMC Hanover | Hanover | $3,216.00 | $445.28 – $890.56 |