Core ndl bx lng/med perq at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$3,199.80
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.
$5,333.00
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.
$154.20 with Highmark Wholecare (prev Gateway) vs $9,561.00 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $154.20 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $157.85 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $163.92 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $165.37 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $176.86 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $206.92 | ↓ -94% |
| Prime Net | Managed Medicare | $730.62 | ↓ -77% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $1,066.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,066.60 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $1,108.04 | ↓ -65% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,534.45 | ↓ -52% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,534.45 | ↓ -52% |
| Humana | Medicare | $1,549.95 | ↓ -52% |
| Aetna | Medicare | $1,616.60 | ↓ -49% |
| Cigna | Medicare | $1,627.45 | ↓ -49% |
| Geisinger | Medicare | $1,627.45 | ↓ -49% |
| United Healthcare | Medicare | $1,658.45 | ↓ -48% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,673.95 | ↓ -48% |
| Prime Net | Legacy Commercial | $2,079.87 | ↓ -35% |
| Prime Net | ACO | $2,095.87 | ↓ -34% |
| Aetna | ACO | $2,095.87 | ↓ -34% |
| UPMC Health Plan | CHIP | $2,131.25 | ↓ -33% |
| Prime Net | NonGateKeeper | $2,479.84 | ↓ -23% |
| Keystone Autism Services | ACAP | $2,479.92 | ↓ -22% |
| Aetna | Commercial | $2,495.84 | ↓ -22% |
| Prime Net | GateKeeper | $2,495.84 | ↓ -22% |
| Capital Blue Cross | Commercial | $2,917.15 | ↓ -9% |
| Capital Blue Cross | CHIP | $2,917.15 | ↓ -9% |
| Keystone Health Plan | Commercial | $2,917.15 | ↓ -9% |
| Wellspan Population Health | PPO | $3,466.45 | ↑ +8% |
| Geisinger | Commercial | $3,492.05 | ↑ +9% |
| UPMC Health Plan | Commercial | $3,733.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $4,031.75 | ↑ +26% |
| Highmark BCBS of PA | Community Blue PPO | $4,359.39 | ↑ +36% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,533.05 | ↑ +42% |
| Highmark BCBS of PA | CHIP - Managed Care | $4,543.83 | ↑ +42% |
| Highmark BCBS of PA | Commercial | $4,843.75 | ↑ +51% |
| Cigna | Commercial | $9,561.00 | ↑ +199% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Core ndl bx lng/med perq at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,911.80 | $121.42 – $3,882.40 |
| UPMC Bedford | Everett | $3,052.80 | $127.49 – $4,579.20 |
| UPMC Community Osteopathic | Harrisburg | $3,199.80 | $163.92 – $4,533.05 |
| UPMC East | Monroeville | $3,052.80 | $133.56 – $4,070.40 |
| UPMC Hamot | Erie | $3,148.20 | $133.56 – $2,246.66 |
| UPMC Northwest | Seneca | $3,052.80 | $133.56 – $1,621.93 |
| UPMC Hanover | Hanover | $3,199.80 | $154.20 – $2,476.51 |
| UPMC Horizon-Greenville | Greenville | $3,052.80 | $133.56 – $1,668.28 |