Coronary angio/cath placement bypass graft/lv gram/lt heart at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$6,234.00
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.
$10,390.00
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 $17,298.00 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -84% |
| Prime Net | Managed Medicare | $1,423.43 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,692.28 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $1,808.82 | ↓ -71% |
| Keystone Health Plan | Medicare Advantage | $2,078.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,078.00 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $3,046.11 | ↓ -51% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $3,046.11 | ↓ -51% |
| Humana | Medicare | $3,076.88 | ↓ -51% |
| Aetna | Medicare | $3,209.19 | ↓ -49% |
| Geisinger | Medicare | $3,230.72 | ↓ -48% |
| Cigna | Medicare | $3,230.72 | ↓ -48% |
| United Healthcare | Medicare | $3,292.26 | ↓ -47% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,323.03 | ↓ -47% |
| Prime Net | Legacy Commercial | $4,052.10 | ↓ -35% |
| Prime Net | ACO | $4,083.27 | ↓ -35% |
| Aetna | ACO | $4,270.29 | ↓ -32% |
| Prime Net | NonGateKeeper | $4,831.35 | ↓ -23% |
| Prime Net | GateKeeper | $4,862.52 | ↓ -22% |
| Keystone Autism Services | ACAP | $4,923.01 | ↓ -21% |
| Aetna | Commercial | $5,080.71 | ↓ -19% |
| UPMC Health Plan | CHIP | $5,577.26 | ↓ -11% |
| Capital Blue Cross | Commercial | $5,683.33 | ↓ -9% |
| Keystone Health Plan | Commercial | $5,683.33 | ↓ -9% |
| Capital Blue Cross | CHIP | $5,683.33 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $5,714.50 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $5,714.50 | ↓ -8% |
| Wellspan Population Health | PPO | $6,753.50 | ↑ +8% |
| Geisinger | Commercial | $6,803.37 | ↑ +9% |
| UPMC Health Plan | Commercial | $7,273.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $7,854.84 | ↑ +26% |
| Highmark BCBS of PA | Community Blue PPO | $8,654.03 | ↑ +39% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $8,831.50 | ↑ +42% |
| Highmark BCBS of PA | CHIP - Managed Care | $9,020.18 | ↑ +45% |
| Highmark BCBS of PA | Commercial | $9,615.56 | ↑ +54% |
| Cigna | Commercial | $17,298.00 | ↑ +177% |
| 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
Coronary angio/cath placement bypass graft/lv gram/lt heart at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $10,891.20 | $1,433.67 – $14,521.60 |
| UPMC Community Osteopathic | Harrisburg | $6,234.00 | $1,016.56 – $8,831.50 |
| UPMC East | Monroeville | $7,418.40 | $1,447.33 – $9,891.20 |
| UPMC Hamot | Erie | $25,078.20 | $1,433.67 – $4,459.95 |
| UPMC Northwest | Seneca | $9,024.60 | $1,728.43 – $3,311.78 |
| UPMC Hanover | Hanover | $6,234.00 | $1,016.56 – $5,577.26 |
| UPMC Jameson | New Castle | $4,585.80 | $892.40 – $3,833.07 |
| UPMC Lititz | Lititz | $6,234.00 | $1,016.56 – $5,577.26 |