Critical care 30-74 minutes at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2,304.00
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.
$3,840.00
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.
$192.57 with AmeriHealth Caritas vs $3,264.00 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $192.57 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $192.57 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $197.12 | ↓ -91% |
| United Healthcare Community Plan for Families | PA Medicaid | $198.64 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $206.52 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $220.86 | ↓ -90% |
| PA Health & Wellness | PA Medicaid HMO | $258.41 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $359.59 | ↓ -84% |
| Prime Net | Managed Medicare | $526.08 | ↓ -77% |
| UPMC Health Plan | CHIP | $582.06 | ↓ -75% |
| Capital Blue Cross | Medicare Advantage | $768.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $768.00 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $798.00 | ↓ -65% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $798.00 | ↓ -65% |
| Humana | Medicare | $806.06 | ↓ -65% |
| Aetna | Medicare | $840.72 | ↓ -64% |
| Geisinger | Medicare | $846.36 | ↓ -63% |
| Cigna | Medicare | $846.36 | ↓ -63% |
| United Healthcare | Medicare | $862.48 | ↓ -63% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $870.54 | ↓ -62% |
| Keystone Autism Services | ACAP | $1,289.70 | ↓ -44% |
| Prime Net | Legacy Commercial | $1,497.60 | ↓ -35% |
| Aetna | ACO | $1,509.12 | ↓ -35% |
| Prime Net | ACO | $1,509.12 | ↓ -35% |
| Prime Net | NonGateKeeper | $1,785.60 | ↓ -23% |
| Prime Net | GateKeeper | $1,797.12 | ↓ -22% |
| Aetna | Commercial | $1,797.12 | ↓ -22% |
| Cigna | Commercial | $2,050.00 | ↓ -11% |
| Capital Blue Cross | CHIP | $2,100.48 | ↓ -9% |
| Capital Blue Cross | Commercial | $2,100.48 | ↓ -9% |
| Keystone Health Plan | Commercial | $2,100.48 | ↓ -9% |
| Highmark BCBS of PA | Community Blue PPO | $2,267.12 | ↓ -2% |
| Highmark BCBS of PA | CHIP - Managed Care | $2,363.05 | ↑ +3% |
| Wellspan Population Health | PPO | $2,496.00 | ↑ +8% |
| Geisinger | Commercial | $2,514.43 | ↑ +9% |
| Highmark BCBS of PA | Commercial | $2,519.02 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,688.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,903.04 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,264.00 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Critical care 30-74 minutes at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,460.60 | $151.63 – $3,280.80 |
| UPMC Bedford | Everett | $1,087.80 | $159.21 – $1,631.70 |
| UPMC Cole | Coudersport | $1,185.60 | $159.21 – $553.28 |
| UPMC Community Osteopathic | Harrisburg | $2,304.00 | $192.57 – $1,303.05 |
| UPMC East | Monroeville | $1,501.80 | $166.79 – $2,002.40 |
| UPMC Hamot | Erie | $2,664.00 | $166.79 – $1,001.31 |
| UPMC Northwest | Seneca | $1,263.00 | $166.79 – $843.50 |
| UPMC Hanover | Hanover | $2,304.00 | $192.57 – $1,287.92 |