Complx repair trunk 1.1-2.5 cm 13100 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,927.80
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.
$3,213.00
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.
$76.20 with AmeriHealth Caritas vs $2,731.05 with Multiplan — 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 | $76.20 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $76.20 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $78.00 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $81.72 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $87.40 | ↓ -95% |
| PA Health & Wellness | PA Medicaid HMO | $102.25 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $361.79 | ↓ -81% |
| Prime Net | Managed Medicare | $440.18 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $579.72 | ↓ -70% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $579.72 | ↓ -70% |
| Humana | Medicare | $585.58 | ↓ -70% |
| Aetna | Medicare | $610.76 | ↓ -68% |
| Cigna | Medicare | $614.86 | ↓ -68% |
| Geisinger | Medicare | $614.86 | ↓ -68% |
| United Healthcare | Medicare | $626.57 | ↓ -67% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $632.43 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $642.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $642.60 | ↓ -67% |
| Keystone Autism Services | ACAP | $936.93 | ↓ -51% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -47% |
| Prime Net | Legacy Commercial | $1,253.07 | ↓ -35% |
| Prime Net | ACO | $1,262.71 | ↓ -34% |
| Aetna | ACO | $1,262.71 | ↓ -34% |
| Prime Net | NonGateKeeper | $1,494.05 | ↓ -22% |
| Aetna | Commercial | $1,503.68 | ↓ -22% |
| Prime Net | GateKeeper | $1,503.68 | ↓ -22% |
| Highmark BCBS of PA | Community Blue PPO | $1,647.00 | ↓ -15% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,716.69 | ↓ -11% |
| Capital Blue Cross | Commercial | $1,757.51 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,757.51 | ↓ -9% |
| Capital Blue Cross | CHIP | $1,757.51 | ↓ -9% |
| Highmark BCBS of PA | Commercial | $1,830.00 | ↓ -5% |
| Wellspan Population Health | PPO | $2,088.45 | ↑ +8% |
| Geisinger | Commercial | $2,103.87 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,249.10 | ↑ +17% |
| UPMC Health Plan | CHIP | $2,298.80 | ↑ +19% |
| Prime Net | FH-Medical Rental | $2,429.03 | ↑ +26% |
| Cigna | Commercial | $2,506.14 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,731.05 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Complx repair trunk 1.1-2.5 cm 13100 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,693.20 | $63.00 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $1,927.80 | $76.20 – $2,731.05 |
| UPMC Hanover | Hanover | $1,927.80 | $76.20 – $1,016.56 |
| UPMC Lititz | Lititz | $1,927.80 | $76.20 – $1,016.56 |
| UPMC Memorial | York | $1,927.80 | $76.20 – $1,016.56 |
| UPMC Mercy | Pittsburgh | $4,115.40 | $66.00 – $729.80 |
| UPMC Passavant-McCandless | Pittsburgh | $3,769.20 | $66.00 – $736.75 |
| UPMC Presbyterian | Pittsburgh | $5,677.80 | $66.00 – $931.20 |