healthcosts.net
Clsd/shoulder dislo/manip/no anest 23650 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$856.20
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.
$1,427.00
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.
$125.73 with Highmark Wholecare (prev Gateway) vs $1,731.91 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 | $125.73 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $125.73 | ↓ -85% |
| UPMC Health Plan | Managed Medicaid | $128.70 | ↓ -85% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $134.84 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $144.20 | ↓ -83% |
| PA Health & Wellness | PA Medicaid HMO | $168.72 | ↓ -80% |
| Prime Net | Managed Medicare | $195.50 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $227.18 | ↓ -73% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $227.18 | ↓ -73% |
| Humana | Medicare | $229.47 | ↓ -73% |
| Aetna | Medicare | $239.34 | ↓ -72% |
| Geisinger | Medicare | $240.94 | ↓ -72% |
| Cigna | Medicare | $240.94 | ↓ -72% |
| United Healthcare | Medicare | $245.53 | ↓ -71% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.83 | ↓ -71% |
| Capital Blue Cross | Medicare Advantage | $285.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $285.40 | ↓ -67% |
| Keystone Autism Services | ACAP | $367.15 | ↓ -57% |
| Prime Net | Legacy Commercial | $556.53 | ↓ -35% |
| UPMC Work Partners | Workers Comp | $560.40 | ↓ -35% |
| Prime Net | ACO | $560.81 | ↓ -35% |
| Aetna | ACO | $560.81 | ↓ -35% |
| Highmark BCBS of PA | Community Blue PPO | $645.41 | ↓ -25% |
| Prime Net | NonGateKeeper | $663.55 | ↓ -23% |
| Aetna | Commercial | $667.84 | ↓ -22% |
| Prime Net | GateKeeper | $667.84 | ↓ -22% |
| Highmark BCBS of PA | CHIP - Managed Care | $672.71 | ↓ -21% |
| Highmark BCBS of PA | Commercial | $717.12 | ↓ -16% |
| Capital Blue Cross | CHIP | $780.57 | ↓ -9% |
| Capital Blue Cross | Commercial | $780.57 | ↓ -9% |
| Keystone Health Plan | Commercial | $780.57 | ↓ -9% |
| Wellspan Population Health | PPO | $927.55 | ↑ +8% |
| Geisinger | Commercial | $934.40 | ↑ +9% |
| UPMC Health Plan | Commercial | $998.90 | ↑ +17% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +19% |
| Prime Net | FH-Medical Rental | $1,078.81 | ↑ +26% |
| Cigna | Commercial | $1,113.06 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,212.95 | ↑ +42% |
| UPMC Health Plan | CHIP | $1,731.91 | ↑ +102% |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Clsd/shoulder dislo/manip/no anest 23650 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,425.80 | $99.00 – $3,234.40 |
| UPMC Bedford | Everett | $1,214.40 | $82.51 – $1,821.60 |
| UPMC Northwest | Seneca | $1,632.60 | $108.90 – $2,312.85 |
| UPMC Mercy | Pittsburgh | $1,980.60 | $108.90 – $2,970.90 |
| UPMC Muncy | Muncy | $825.60 | $108.90 – $1,100.80 |
| UPMC Passavant-McCandless | Pittsburgh | $1,547.40 | $108.90 – $2,192.15 |
| UPMC Presbyterian | Pittsburgh | $3,560.40 | $108.90 – $5,043.90 |
| UPMC Somerset | Somerset | $856.20 | $108.90 – $1,070.25 |