Clsd tx/fx grt toe/phalanx/phalang 28490 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$370.80
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.
$618.00
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.
$69.85 with AmeriHealth Caritas vs $717.12 with Highmark BCBS of PA — 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 | $69.85 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $69.85 | ↓ -81% |
| UPMC Health Plan | Managed Medicaid | $71.50 | ↓ -81% |
| United Healthcare Community Plan for Families | PA Medicaid | $72.05 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $74.91 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $80.11 | ↓ -78% |
| Prime Net | Managed Medicare | $84.67 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $93.73 | ↓ -75% |
| Keystone Health Plan | Medicare Advantage | $123.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $123.60 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $199.30 | ↓ -46% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $227.18 | ↓ -39% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $227.18 | ↓ -39% |
| Humana | Medicare | $229.47 | ↓ -38% |
| Aetna | Medicare | $239.34 | ↓ -35% |
| Geisinger | Medicare | $240.94 | ↓ -35% |
| Cigna | Medicare | $240.94 | ↓ -35% |
| Prime Net | Legacy Commercial | $241.02 | ↓ -35% |
| Prime Net | ACO | $242.87 | ↓ -35% |
| Aetna | ACO | $242.87 | ↓ -35% |
| United Healthcare | Medicare | $245.53 | ↓ -34% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.83 | ↓ -33% |
| Prime Net | NonGateKeeper | $287.37 | ↓ -23% |
| Aetna | Commercial | $289.22 | ↓ -22% |
| Prime Net | GateKeeper | $289.22 | ↓ -22% |
| UPMC Health Plan | CHIP | $301.90 | ↓ -19% |
| Keystone Health Plan | Commercial | $338.05 | ↓ -9% |
| Capital Blue Cross | Commercial | $338.05 | ↓ -9% |
| Capital Blue Cross | CHIP | $338.05 | ↓ -9% |
| Keystone Autism Services | ACAP | $367.15 | ↓ -1% |
| Wellspan Population Health | PPO | $401.70 | ↑ +8% |
| Geisinger | Commercial | $404.67 | ↑ +9% |
| UPMC Health Plan | Commercial | $432.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $467.21 | ↑ +26% |
| Cigna | Commercial | $482.04 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $525.30 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $645.41 | ↑ +74% |
| Highmark BCBS of PA | CHIP - Managed Care | $672.71 | ↑ +81% |
| Highmark BCBS of PA | Commercial | $717.12 | ↑ +93% |
| 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
Clsd tx/fx grt toe/phalanx/phalang 28490 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $357.00 | $57.75 – $535.50 |
| UPMC Cole | Coudersport | $459.60 | $31.88 – $190.44 |
| UPMC Community Osteopathic | Harrisburg | $370.80 | $69.85 – $525.30 |
| UPMC Hanover | Hanover | $370.80 | $69.85 – $366.66 |
| UPMC Kane | Kane | $397.80 | $60.50 – $598.93 |
| UPMC Lititz | Lititz | $370.80 | $69.85 – $368.64 |
| UPMC Memorial | York | $370.80 | $69.85 – $368.03 |
| UPMC Muncy | Muncy | $825.60 | $60.50 – $216.31 |