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Colonoscopy (with biopsy) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
not published by hospital
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.
not published by hospital
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.
$286.28 with Highmark Wholecare (prev Gateway) vs $5,035.00 with Cigna — 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 | $286.28 | — |
| UPMC Health Plan | Managed Medicaid | $293.05 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $304.32 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $307.02 | — |
| Geisinger | Medicaid/CHIP | $328.35 | — |
| PA Health & Wellness | PA Medicaid HMO | $384.16 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $419.20 | — |
| UPMC Work Partners | Workers Comp | $880.48 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,116.65 | — |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,116.65 | — |
| Humana | Medicare | $1,127.93 | — |
| Aetna | Medicare | $1,176.43 | — |
| Cigna | Medicare | $1,184.33 | — |
| Geisinger | Medicare | $1,184.33 | — |
| United Healthcare | Medicare | $1,206.89 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,218.16 | — |
| Keystone Autism Services | ACAP | $1,804.69 | — |
| UPMC Health Plan | CHIP | $2,298.97 | — |
| Highmark BCBS of PA | Community Blue PPO | $3,172.42 | — |
| Highmark BCBS of PA | CHIP - Managed Care | $3,306.64 | — |
| Highmark BCBS of PA | Commercial | $3,524.89 | — |
| Cigna | Commercial | $5,035.00 | — |
| 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
Colonoscopy (with biopsy) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,214.00 | $247.96 – $3,136.50 |
| UPMC East | Monroeville | $3,055.20 | $247.96 – $4,073.60 |
| UPMC Hamot | Erie | $3,099.00 | $247.96 – $3,615.50 |
| UPMC Altoona | Altoona | $1,764.60 | $225.42 – $2,352.80 |
| UPMC Bedford | Everett | $1,656.60 | $236.69 – $2,484.90 |
| UPMC Cole | Coudersport | $727.20 | $236.69 – $1,041.88 |
| UPMC Horizon-Greenville | Greenville | $2,476.20 | $247.96 – $3,507.95 |
| UPMC Jameson | New Castle | $2,476.20 | $247.96 – $3,631.76 |