Closed tx humerus fx without manip 23600 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$447.60
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.
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What you pay up front if you don't use insurance.
$746.00
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.
$102.20 with Prime Net vs $1,732.19 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $102.20 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $147.96 | ↓ -67% |
| Highmark Wholecare (prev Gateway) | Medicaid | $147.96 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $149.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $149.20 | ↓ -67% |
| UPMC Health Plan | Managed Medicaid | $151.45 | ↓ -66% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $158.67 | ↓ -65% |
| Geisinger | Medicaid/CHIP | $169.69 | ↓ -62% |
| PA Health & Wellness | PA Medicaid HMO | $198.54 | ↓ -56% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $227.18 | ↓ -49% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $227.18 | ↓ -49% |
| Humana | Medicare | $229.47 | ↓ -49% |
| Aetna | Medicare | $239.34 | ↓ -47% |
| Cigna | Medicare | $240.94 | ↓ -46% |
| Geisinger | Medicare | $240.94 | ↓ -46% |
| United Healthcare | Medicare | $245.53 | ↓ -45% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.83 | ↓ -45% |
| Prime Net | Legacy Commercial | $290.94 | ↓ -35% |
| Aetna | ACO | $293.18 | ↓ -34% |
| Prime Net | ACO | $293.18 | ↓ -34% |
| Prime Net | NonGateKeeper | $346.89 | ↓ -23% |
| Prime Net | GateKeeper | $349.13 | ↓ -22% |
| Aetna | Commercial | $349.13 | ↓ -22% |
| Keystone Autism Services | ACAP | $367.15 | ↓ -18% |
| Capital Blue Cross | CHIP | $408.06 | ↓ -9% |
| Capital Blue Cross | Commercial | $408.06 | ↓ -9% |
| Keystone Health Plan | Commercial | $408.06 | ↓ -9% |
| Wellspan Population Health | PPO | $484.90 | ↑ +8% |
| Geisinger | Commercial | $488.48 | ↑ +9% |
| UPMC Health Plan | Commercial | $522.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $563.98 | ↑ +26% |
| Cigna | Commercial | $581.88 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $634.10 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $645.41 | ↑ +44% |
| UPMC Work Partners | Workers Comp | $668.12 | ↑ +49% |
| Highmark BCBS of PA | CHIP - Managed Care | $672.71 | ↑ +50% |
| Highmark BCBS of PA | Commercial | $717.12 | ↑ +60% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +127% |
| UPMC Health Plan | CHIP | $1,732.19 | ↑ +287% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Closed tx humerus fx without manip 23600 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $2,557.20 | $82.51 – $3,835.80 |
| UPMC Cole | Coudersport | $1,266.00 | $72.90 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $447.60 | $147.96 – $1,732.19 |
| UPMC Hanover | Hanover | $447.60 | $147.96 – $1,016.56 |
| UPMC Kane | Kane | $397.80 | $128.15 – $1,428.51 |
| UPMC Lititz | Lititz | $447.60 | $147.96 – $1,016.56 |
| UPMC Memorial | York | $447.60 | $147.96 – $1,016.56 |
| UPMC Muncy | Muncy | $825.60 | $128.15 – $993.28 |