healthcosts.net
Clsd tx humerus fract without manip 24500 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$759.00
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.
$1,265.00
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.
$142.24 with Highmark Wholecare (prev Gateway) vs $1,732.25 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 | $142.24 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $142.24 | ↓ -81% |
| UPMC Health Plan | Managed Medicaid | $145.60 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $152.54 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $163.14 | ↓ -79% |
| Prime Net | Managed Medicare | $173.31 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $190.87 | ↓ -75% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $227.18 | ↓ -70% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $227.18 | ↓ -70% |
| Humana | Medicare | $229.47 | ↓ -70% |
| Aetna | Medicare | $239.34 | ↓ -68% |
| Geisinger | Medicare | $240.94 | ↓ -68% |
| Cigna | Medicare | $240.94 | ↓ -68% |
| United Healthcare | Medicare | $245.53 | ↓ -68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.83 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $253.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $253.00 | ↓ -67% |
| Keystone Autism Services | ACAP | $367.15 | ↓ -52% |
| Prime Net | Legacy Commercial | $493.35 | ↓ -35% |
| Aetna | ACO | $497.14 | ↓ -35% |
| Prime Net | ACO | $497.14 | ↓ -35% |
| Prime Net | NonGateKeeper | $588.23 | ↓ -22% |
| Aetna | Commercial | $592.02 | ↓ -22% |
| Prime Net | GateKeeper | $592.02 | ↓ -22% |
| UPMC Work Partners | Workers Comp | $628.79 | ↓ -17% |
| Highmark BCBS of PA | Community Blue PPO | $645.41 | ↓ -15% |
| Highmark BCBS of PA | CHIP - Managed Care | $672.71 | ↓ -11% |
| Keystone Health Plan | Commercial | $691.96 | ↓ -9% |
| Capital Blue Cross | Commercial | $691.96 | ↓ -9% |
| Capital Blue Cross | CHIP | $691.96 | ↓ -9% |
| Highmark BCBS of PA | Commercial | $717.12 | ↓ -6% |
| Wellspan Population Health | PPO | $822.25 | ↑ +8% |
| Geisinger | Commercial | $828.32 | ↑ +9% |
| UPMC Health Plan | Commercial | $885.50 | ↑ +17% |
| Prime Net | FH-Medical Rental | $956.34 | ↑ +26% |
| Cigna | Commercial | $986.70 | ↑ +30% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +34% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,075.25 | ↑ +42% |
| UPMC Health Plan | CHIP | $1,732.25 | ↑ +128% |
| 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 tx humerus fract without manip 24500 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Muncy | Muncy | $825.60 | $123.20 – $1,100.80 |
| UPMC Somerset | Somerset | $759.00 | $123.20 – $948.75 |
| UPMC Wellsboro | Wellsboro | $998.40 | $123.20 – $1,123.20 |
| UPMC Williamsport | Williamsport | $3,355.20 | $123.20 – $4,473.60 |