Consultation pathology during surgery frozen section first tissue block at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$337.20
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.
$562.00
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.
$9.82 with United Healthcare Community Plan for Families vs $512.30 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 | $9.82 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $32.50 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $41.27 | ↓ -88% |
| UPMC Health Plan | Managed Medicaid | $42.25 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $44.27 | ↓ -87% |
| Geisinger | Medicaid/CHIP | $47.34 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $55.39 | ↓ -84% |
| Prime Net | Managed Medicare | $76.99 | ↓ -77% |
| Cigna | Commercial | $91.00 | ↓ -73% |
| UPMC Health Plan | CHIP | $102.20 | ↓ -70% |
| Capital Blue Cross | Medicare Advantage | $112.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $112.40 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $162.29 | ↓ -52% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $162.29 | ↓ -52% |
| Humana | Medicare | $163.93 | ↓ -51% |
| Aetna | Medicare | $170.98 | ↓ -49% |
| Geisinger | Medicare | $172.13 | ↓ -49% |
| Cigna | Medicare | $172.13 | ↓ -49% |
| United Healthcare | Medicare | $175.41 | ↓ -48% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $177.04 | ↓ -47% |
| UPMC Work Partners | Workers Comp | $209.21 | ↓ -38% |
| Prime Net | Legacy Commercial | $219.18 | ↓ -35% |
| Aetna | ACO | $220.87 | ↓ -34% |
| Prime Net | ACO | $220.87 | ↓ -34% |
| Prime Net | NonGateKeeper | $261.33 | ↓ -23% |
| Keystone Autism Services | ACAP | $262.29 | ↓ -22% |
| Aetna | Commercial | $263.02 | ↓ -22% |
| Prime Net | GateKeeper | $263.02 | ↓ -22% |
| Capital Blue Cross | CHIP | $307.41 | ↓ -9% |
| Keystone Health Plan | Commercial | $307.41 | ↓ -9% |
| Capital Blue Cross | Commercial | $307.41 | ↓ -9% |
| Wellspan Population Health | PPO | $365.30 | ↑ +8% |
| Geisinger | Commercial | $368.00 | ↑ +9% |
| UPMC Health Plan | Commercial | $393.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $424.87 | ↑ +26% |
| Highmark BCBS of PA | Community Blue PPO | $461.07 | ↑ +37% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $477.70 | ↑ +42% |
| Highmark BCBS of PA | CHIP - Managed Care | $480.58 | ↑ +43% |
| Highmark BCBS of PA | Commercial | $512.30 | ↑ +52% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Consultation pathology during surgery frozen section first tissue block at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $229.80 | $7.50 – $306.40 |
| UPMC Bedford | Everett | $133.20 | $28.50 – $199.91 |
| UPMC Cole | Coudersport | $104.40 | $34.12 – $199.91 |
| UPMC Community Osteopathic | Harrisburg | $337.20 | $9.82 – $211.89 |
| UPMC East | Monroeville | $303.00 | $28.11 – $404.00 |
| UPMC Hamot | Erie | $717.00 | $23.43 – $213.56 |
| UPMC Northwest | Seneca | $159.60 | $28.38 – $202.47 |
| UPMC Hanover | Hanover | $337.20 | $9.82 – $261.92 |