Consultation pathology during surgery cytological exam initial site at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,472.40
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.
$2,454.00
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.
$20.97 with United Healthcare Community Plan for Families vs $2,442.14 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $20.97 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $67.87 | ↓ -95% |
| Cigna | Commercial | $69.44 | ↓ -95% |
| UPMC Health Plan | CHIP | $83.50 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $86.19 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $88.23 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $92.44 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $98.86 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $115.66 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $149.00 | ↓ -90% |
| Prime Net | Managed Medicare | $336.20 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $490.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $490.80 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $773.65 | ↓ -47% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $773.65 | ↓ -47% |
| Humana | Medicare | $781.46 | ↓ -47% |
| Aetna | Medicare | $815.06 | ↓ -45% |
| Cigna | Medicare | $820.53 | ↓ -44% |
| Geisinger | Medicare | $820.53 | ↓ -44% |
| United Healthcare | Medicare | $836.16 | ↓ -43% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $843.98 | ↓ -43% |
| Prime Net | Legacy Commercial | $957.06 | ↓ -35% |
| Prime Net | ACO | $964.42 | ↓ -35% |
| Aetna | ACO | $964.42 | ↓ -35% |
| Prime Net | NonGateKeeper | $1,141.11 | ↓ -23% |
| Aetna | Commercial | $1,148.47 | ↓ -22% |
| Prime Net | GateKeeper | $1,148.47 | ↓ -22% |
| Keystone Autism Services | ACAP | $1,250.34 | ↓ -15% |
| Capital Blue Cross | CHIP | $1,342.34 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,342.34 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,342.34 | ↓ -9% |
| Wellspan Population Health | PPO | $1,595.10 | ↑ +8% |
| Geisinger | Commercial | $1,606.88 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,717.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,855.22 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,085.90 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $2,197.93 | ↑ +49% |
| Highmark BCBS of PA | CHIP - Managed Care | $2,290.93 | ↑ +56% |
| Highmark BCBS of PA | Commercial | $2,442.14 | ↑ +66% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Consultation pathology during surgery cytological exam initial site at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $100.20 | $16.01 – $133.60 |
| UPMC Bedford | Everett | $235.20 | $23.28 – $352.80 |
| UPMC Cole | Coudersport | $280.20 | $53.00 – $373.60 |
| UPMC Community Osteopathic | Harrisburg | $1,472.40 | $20.97 – $2,085.90 |
| UPMC East | Monroeville | $287.40 | $22.97 – $817.76 |
| UPMC Hamot | Erie | $93.60 | $23.43 – $970.76 |
| UPMC Northwest | Seneca | $231.60 | $23.18 – $817.76 |
| UPMC Hanover | Hanover | $1,472.40 | $20.97 – $1,248.61 |