Convert nephrostomy catheter at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$4,953.00
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.
$8,255.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $7,016.75 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -79% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,077.81 | ↓ -78% |
| Prime Net | Managed Medicare | $1,130.93 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $1,207.50 | ↓ -76% |
| Keystone Health Plan | Medicare Advantage | $1,651.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,651.00 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,940.05 | ↓ -61% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,940.05 | ↓ -61% |
| Humana | Medicare | $1,959.65 | ↓ -60% |
| Aetna | Medicare | $2,043.91 | ↓ -59% |
| Geisinger | Medicare | $2,057.63 | ↓ -58% |
| Cigna | Medicare | $2,057.63 | ↓ -58% |
| United Healthcare | Medicare | $2,096.83 | ↓ -58% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,116.42 | ↓ -57% |
| Keystone Autism Services | ACAP | $3,135.44 | ↓ -37% |
| Prime Net | Legacy Commercial | $3,219.45 | ↓ -35% |
| Aetna | ACO | $3,244.22 | ↓ -34% |
| Prime Net | ACO | $3,244.22 | ↓ -34% |
| Prime Net | NonGateKeeper | $3,838.57 | ↓ -23% |
| Prime Net | GateKeeper | $3,863.34 | ↓ -22% |
| Aetna | Commercial | $3,863.34 | ↓ -22% |
| Keystone Health Plan | Commercial | $4,515.48 | ↓ -9% |
| Capital Blue Cross | CHIP | $4,515.48 | ↓ -9% |
| Capital Blue Cross | Commercial | $4,515.48 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $4,540.25 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $4,540.25 | ↓ -8% |
| Wellspan Population Health | PPO | $5,365.75 | ↑ +8% |
| Geisinger | Commercial | $5,405.37 | ↑ +9% |
| Highmark BCBS of PA | Community Blue PPO | $5,511.71 | ↑ +11% |
| Highmark BCBS of PA | CHIP - Managed Care | $5,744.91 | ↑ +16% |
| UPMC Health Plan | CHIP | $5,778.50 | ↑ +17% |
| UPMC Health Plan | Commercial | $5,778.50 | ↑ +17% |
| Highmark BCBS of PA | Commercial | $6,124.10 | ↑ +24% |
| Prime Net | FH-Medical Rental | $6,240.78 | ↑ +26% |
| Cigna | Commercial | $6,413.00 | ↑ +29% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $7,016.75 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Convert nephrostomy catheter at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,405.40 | $602.44 – $3,207.20 |
| UPMC Community Osteopathic | Harrisburg | $4,953.00 | $1,016.56 – $7,016.75 |
| UPMC East | Monroeville | $3,058.80 | $608.17 – $4,078.40 |
| UPMC Hamot | Erie | $3,019.80 | $602.44 – $2,840.52 |
| UPMC Northwest | Seneca | $2,643.00 | $1,153.84 – $2,109.25 |
| UPMC Hanover | Hanover | $4,953.00 | $1,016.56 – $3,131.10 |
| UPMC Lititz | Lititz | $4,953.00 | $1,016.56 – $3,148.02 |
| UPMC Magee | Pittsburgh | $3,548.40 | $608.17 – $2,148.31 |