Close lac/mouth vest/2.5 cm or < 40830 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$777.60
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.
?
What you pay up front if you don't use insurance.
$1,296.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$40.01 with AmeriHealth Caritas vs $1,101.60 with Multiplan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $40.01 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $40.01 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $40.95 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $42.90 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $45.88 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $53.68 | ↓ -93% |
| Prime Net | Managed Medicare | $177.55 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $218.71 | ↓ -72% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $219.93 | ↓ -72% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $219.93 | ↓ -72% |
| Humana | Medicare | $222.15 | ↓ -71% |
| Aetna | Medicare | $231.70 | ↓ -70% |
| Cigna | Medicare | $233.26 | ↓ -70% |
| Geisinger | Medicare | $233.26 | ↓ -70% |
| United Healthcare | Medicare | $237.70 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $239.92 | ↓ -69% |
| Keystone Health Plan | Medicare Advantage | $259.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $259.20 | ↓ -67% |
| Keystone Autism Services | ACAP | $355.44 | ↓ -54% |
| UPMC Health Plan | CHIP | $401.80 | ↓ -48% |
| Prime Net | Legacy Commercial | $505.44 | ↓ -35% |
| Prime Net | ACO | $509.33 | ↓ -34% |
| Aetna | ACO | $509.33 | ↓ -34% |
| Prime Net | NonGateKeeper | $602.64 | ↓ -23% |
| Aetna | Commercial | $606.53 | ↓ -22% |
| Prime Net | GateKeeper | $606.53 | ↓ -22% |
| Highmark BCBS of PA | Community Blue PPO | $624.82 | ↓ -20% |
| United Healthcare Community Plan for Families | PA Medicaid | $645.83 | ↓ -17% |
| Highmark BCBS of PA | CHIP - Managed Care | $651.25 | ↓ -16% |
| Highmark BCBS of PA | Commercial | $694.24 | ↓ -11% |
| Capital Blue Cross | Commercial | $708.91 | ↓ -9% |
| Capital Blue Cross | CHIP | $708.91 | ↓ -9% |
| Keystone Health Plan | Commercial | $708.91 | ↓ -9% |
| Wellspan Population Health | PPO | $842.40 | ↑ +8% |
| Geisinger | Commercial | $848.62 | ↑ +9% |
| UPMC Health Plan | Commercial | $907.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $979.78 | ↑ +26% |
| Cigna | Commercial | $1,010.88 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,101.60 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Close lac/mouth vest/2.5 cm or < 40830 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $530.40 | $31.50 – $707.20 |
| UPMC Bedford | Everett | $898.20 | $33.08 – $1,347.30 |
| UPMC Community Osteopathic | Harrisburg | $777.60 | $40.01 – $1,101.60 |
| UPMC East | Monroeville | $660.00 | $34.65 – $880.00 |
| UPMC Hamot | Erie | $496.80 | $34.65 – $322.01 |
| UPMC Northwest | Seneca | $388.80 | $34.65 – $232.46 |
| UPMC Hanover | Hanover | $777.60 | $40.01 – $645.83 |
| UPMC Horizon-Greenville | Greenville | $550.80 | $34.65 – $253.13 |