Circumcise/surg/28 days or < 54160 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,219.20
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.
$2,032.00
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.
$162.56 with Highmark Wholecare (prev Gateway) vs $3,614.86 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $162.56 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $162.56 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $174.34 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $186.44 | ↓ -85% |
| PA Health & Wellness | PA Medicaid HMO | $218.14 | ↓ -82% |
| Prime Net | Managed Medicare | $278.38 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $406.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $406.40 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $467.67 | ↓ -62% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $632.13 | ↓ -48% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $632.13 | ↓ -48% |
| Humana | Medicare | $638.52 | ↓ -48% |
| Aetna | Medicare | $665.98 | ↓ -45% |
| Geisinger | Medicare | $670.45 | ↓ -45% |
| Cigna | Medicare | $670.45 | ↓ -45% |
| United Healthcare | Medicare | $683.22 | ↓ -44% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $689.60 | ↓ -43% |
| Prime Net | Legacy Commercial | $792.48 | ↓ -35% |
| Prime Net | ACO | $798.58 | ↓ -34% |
| Aetna | ACO | $798.58 | ↓ -34% |
| Prime Net | NonGateKeeper | $944.88 | ↓ -23% |
| Prime Net | GateKeeper | $950.98 | ↓ -22% |
| Aetna | Commercial | $950.98 | ↓ -22% |
| Keystone Autism Services | ACAP | $1,021.63 | ↓ -16% |
| Keystone Health Plan | Commercial | $1,111.50 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,111.50 | ↓ -9% |
| Capital Blue Cross | CHIP | $1,111.50 | ↓ -9% |
| Wellspan Population Health | PPO | $1,320.80 | ↑ +8% |
| Geisinger | Commercial | $1,330.55 | ↑ +9% |
| United Healthcare | Commercial | $1,495.55 | ↑ +23% |
| UPMC Health Plan | Managed Medicaid | $1,500.00 | ↑ +23% |
| Prime Net | FH-Medical Rental | $1,536.19 | ↑ +26% |
| Cigna | Commercial | $1,584.96 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,727.20 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $1,795.90 | ↑ +47% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,871.89 | ↑ +54% |
| Highmark BCBS of PA | Commercial | $1,995.44 | ↑ +64% |
| UPMC Health Plan | CHIP | $3,000.00 | ↑ +146% |
| UPMC Health Plan | Commercial | $3,614.86 | ↑ +196% |
| Tricare | East Region | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Circumcise/surg/28 days or < 54160 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hanover | Hanover | $1,219.20 | $162.56 – $1,020.21 |
| UPMC Horizon-Greenville | Greenville | $593.40 | $31.88 – $687.26 |
| UPMC Lititz | Lititz | $1,219.20 | $162.56 – $1,025.73 |
| UPMC Memorial | York | $1,219.20 | $106.05 – $1,024.06 |
| WellSpan Chambersburg Hospital | Chambersburg | $433.60 | $160.00 – $3,069.77 |
| WellSpan Ephrata Community Hospital | Ephrata | $433.60 | $160.00 – $435.20 |
| Uniontown Hospital | Uniontown | $801.50 | $140.80 – $1,403.76 |
| WellSpan Good Samaritan Hospital | Lebanon | $433.60 | $160.00 – $5,670.70 |