Change of windpipe airway 31502 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$463.80
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.
$773.00
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.
$105.90 with Prime Net vs $694.24 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $105.90 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $122.18 | ↓ -74% |
| UPMC Work Partners | Workers Comp | $123.08 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $154.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $154.60 | ↓ -67% |
| United Healthcare | Commercial | $163.00 | ↓ -65% |
| United Healthcare Community Plan for Families | PA Medicaid | $166.08 | ↓ -64% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $219.93 | ↓ -53% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $219.93 | ↓ -53% |
| Humana | Medicare | $222.15 | ↓ -52% |
| Aetna | Medicare | $231.70 | ↓ -50% |
| Geisinger | Medicare | $233.26 | ↓ -50% |
| Cigna | Medicare | $233.26 | ↓ -50% |
| United Healthcare | Medicare | $237.70 | ↓ -49% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $239.92 | ↓ -48% |
| UPMC Health Plan | CHIP | $282.41 | ↓ -39% |
| Prime Net | Legacy Commercial | $301.47 | ↓ -35% |
| Aetna | ACO | $303.79 | ↓ -34% |
| Prime Net | ACO | $303.79 | ↓ -34% |
| Keystone Autism Services | ACAP | $355.44 | ↓ -23% |
| Prime Net | NonGateKeeper | $359.44 | ↓ -23% |
| Aetna | Commercial | $361.76 | ↓ -22% |
| Prime Net | GateKeeper | $361.76 | ↓ -22% |
| Cigna | Commercial | $387.00 | ↓ -17% |
| Capital Blue Cross | CHIP | $422.83 | ↓ -9% |
| Capital Blue Cross | Commercial | $422.83 | ↓ -9% |
| Keystone Health Plan | Commercial | $422.83 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $425.15 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $425.15 | ↓ -8% |
| Wellspan Population Health | PPO | $502.45 | ↑ +8% |
| Geisinger | Commercial | $506.16 | ↑ +9% |
| UPMC Health Plan | Commercial | $541.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $584.39 | ↑ +26% |
| Highmark BCBS of PA | Community Blue PPO | $624.82 | ↑ +35% |
| Highmark BCBS of PA | CHIP - Managed Care | $651.25 | ↑ +40% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $657.05 | ↑ +42% |
| Highmark BCBS of PA | Commercial | $694.24 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Change of windpipe airway 31502 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $454.20 | $92.94 – $605.60 |
| UPMC Cole | Coudersport | $220.20 | $10.53 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $463.80 | $124.62 – $657.05 |
| UPMC East | Monroeville | $319.20 | $93.83 – $425.60 |
| UPMC Hamot | Erie | $380.40 | $92.94 – $322.01 |
| UPMC Northwest | Seneca | $580.20 | $119.08 – $239.10 |
| UPMC Hanover | Hanover | $463.80 | $124.62 – $354.94 |
| UPMC Jameson | New Castle | $242.40 | $94.58 – $298.88 |