Contrast x-ray of knee joint at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$896.40
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.
$1,494.00
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.
$21.61 with United Healthcare Community Plan for Families vs $2,006.79 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $21.61 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $34.92 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $34.92 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $35.75 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $37.45 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $40.06 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $46.87 | ↓ -95% |
| Prime Net | Managed Medicare | $204.68 | ↓ -77% |
| Aetna | Medicare | $246.51 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $298.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $298.80 | ↓ -67% |
| Premier Comp Solutions | Worker's Comp | $303.98 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $303.98 | ↓ -66% |
| UPMC Health Plan | CHIP | $469.17 | ↓ -48% |
| Prime Net | Legacy Commercial | $582.66 | ↓ -35% |
| Aetna | ACO | $587.14 | ↓ -35% |
| Prime Net | ACO | $587.14 | ↓ -35% |
| Prime Net | NonGateKeeper | $694.71 | ↓ -23% |
| Aetna | Commercial | $699.19 | ↓ -22% |
| Prime Net | GateKeeper | $699.19 | ↓ -22% |
| Capital Blue Cross | Commercial | $817.22 | ↓ -9% |
| Keystone Health Plan | Commercial | $817.22 | ↓ -9% |
| Capital Blue Cross | CHIP | $817.22 | ↓ -9% |
| Wellspan Population Health | PPO | $971.10 | ↑ +8% |
| Geisinger | Commercial | $978.27 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,045.80 | ↑ +17% |
| United Healthcare | Commercial | $1,099.58 | ↑ +23% |
| Prime Net | FH-Medical Rental | $1,129.46 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,269.90 | ↑ +42% |
| Cigna | Commercial | $2,006.79 | ↑ +124% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Contrast x-ray of knee joint at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $896.40 | $21.61 – $1,269.90 |
| UPMC Hanover | Hanover | $896.40 | $21.61 – $2,006.79 |
| UPMC Kane | Kane | $1,191.60 | $290.47 – $401.13 |
| UPMC Lititz | Lititz | $896.40 | $21.61 – $2,006.79 |
| UPMC McKeesport | Mckeesport | $2,649.60 | $132.48 – $374.53 |
| UPMC Memorial | York | $896.40 | $21.61 – $2,006.79 |
| UPMC Mercy | Pittsburgh | $2,851.20 | $129.44 – $323.33 |
| UPMC Muncy | Muncy | $718.20 | $21.12 – $340.00 |