Chrom analysis at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$126.00
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.
$210.00
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.
$19.15 with AmeriHealth Caritas vs $182.28 with UPMC Health Plan — 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 | $19.15 | ↓ -85% |
| United Healthcare Community Plan for Families | PA Medicaid | $27.81 | ↓ -78% |
| Prime Net | Managed Medicare | $28.77 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $34.46 | ↓ -73% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $34.46 | ↓ -73% |
| Humana | Medicare | $34.81 | ↓ -72% |
| UPMC Work Partners | Workers Comp | $36.01 | ↓ -71% |
| Aetna | Medicare | $36.31 | ↓ -71% |
| Cigna | Medicare | $36.55 | ↓ -71% |
| Geisinger | Medicare | $36.55 | ↓ -71% |
| United Healthcare | Medicare | $37.25 | ↓ -70% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $37.59 | ↓ -70% |
| Capital Blue Cross | Medicare Advantage | $42.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $42.00 | ↓ -67% |
| Highmark Wholecare (prev Gateway) | Medicaid | $46.00 | ↓ -63% |
| Keystone Autism Services | ACAP | $55.70 | ↓ -56% |
| Prime Net | Legacy Commercial | $81.90 | ↓ -35% |
| Aetna | ACO | $82.53 | ↓ -35% |
| Prime Net | ACO | $82.53 | ↓ -35% |
| Cigna | Commercial | $90.52 | ↓ -28% |
| Prime Net | NonGateKeeper | $97.65 | ↓ -23% |
| Highmark BCBS of PA | Community Blue PPO | $97.91 | ↓ -22% |
| Prime Net | GateKeeper | $98.28 | ↓ -22% |
| Aetna | Commercial | $98.28 | ↓ -22% |
| Highmark BCBS of PA | CHIP - Managed Care | $102.05 | ↓ -19% |
| Highmark BCBS of PA | Commercial | $108.78 | ↓ -14% |
| Keystone Health Plan | Commercial | $114.87 | ↓ -9% |
| Capital Blue Cross | Commercial | $114.87 | ↓ -9% |
| Capital Blue Cross | CHIP | $114.87 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $115.50 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $115.50 | ↓ -8% |
| Wellspan Population Health | PPO | $136.50 | ↑ +8% |
| Geisinger | Commercial | $137.51 | ↑ +9% |
| UPMC Health Plan | Commercial | $147.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $158.76 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $178.50 | ↑ +42% |
| UPMC Health Plan | CHIP | $182.28 | ↑ +45% |
Visitor-reported prices
Comments
Chrom analysis at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $123.00 | $34.41 – $164.00 |
| UPMC Bedford | Everett | $234.00 | $12.56 – $351.00 |
| UPMC Community Osteopathic | Harrisburg | $126.00 | $27.81 – $182.28 |
| UPMC Hamot | Erie | $367.20 | $34.41 – $67.21 |
| UPMC Northwest | Seneca | $228.60 | $31.57 – $37.59 |
| UPMC Kane | Kane | $474.60 | $34.41 – $150.24 |
| UPMC Magee | Pittsburgh | $652.20 | $32.58 – $67.85 |
| UPMC Presbyterian | Pittsburgh | $309.60 | $25.48 – $67.85 |