CT heart w/evaluation of calcium without contrast at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$127.20
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.
$212.00
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.
$13.56 with Prime Net vs $419.44 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $13.56 | ↓ -89% |
| Keystone Health Plan | Medicare Advantage | $19.80 | ↓ -84% |
| Capital Blue Cross | Medicare Advantage | $19.80 | ↓ -84% |
| Prime Net | Legacy Commercial | $38.61 | ↓ -70% |
| Prime Net | ACO | $38.91 | ↓ -69% |
| Aetna | ACO | $38.91 | ↓ -69% |
| United Healthcare Community Plan for Families | PA Medicaid | $45.56 | ↓ -64% |
| Prime Net | NonGateKeeper | $46.03 | ↓ -64% |
| Aetna | Commercial | $46.33 | ↓ -64% |
| Prime Net | GateKeeper | $46.33 | ↓ -64% |
| Keystone Health Plan | Commercial | $54.15 | ↓ -57% |
| Capital Blue Cross | CHIP | $54.15 | ↓ -57% |
| Capital Blue Cross | Commercial | $54.15 | ↓ -57% |
| Wellspan Population Health | PPO | $64.35 | ↓ -49% |
| Geisinger | Commercial | $64.83 | ↓ -49% |
| UPMC Health Plan | Commercial | $69.30 | ↓ -46% |
| Highmark Wholecare (prev Gateway) | Medicaid | $72.19 | ↓ -43% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $72.19 | ↓ -43% |
| United Healthcare | Commercial | $72.86 | ↓ -43% |
| UPMC Health Plan | Managed Medicaid | $73.89 | ↓ -42% |
| Prime Net | FH-Medical Rental | $74.84 | ↓ -41% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $77.42 | ↓ -39% |
| Geisinger | Medicaid/CHIP | $82.79 | ↓ -35% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $83.39 | ↓ -34% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $83.39 | ↓ -34% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $84.15 | ↓ -34% |
| Humana | Medicare | $84.23 | ↓ -34% |
| Aetna | Medicare | $87.85 | ↓ -31% |
| Geisinger | Medicare | $88.44 | ↓ -30% |
| Cigna | Medicare | $88.44 | ↓ -30% |
| United Healthcare | Medicare | $90.13 | ↓ -29% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $90.97 | ↓ -28% |
| PA Health & Wellness | PA Medicaid HMO | $96.87 | ↓ -24% |
| UPMC Work Partners | Workers Comp | $112.43 | ↓ -12% |
| Keystone Autism Services | ACAP | $134.77 | ↑ +6% |
| Highmark BCBS of PA | Community Blue PPO | $236.91 | ↑ +86% |
| Highmark BCBS of PA | CHIP - Managed Care | $246.93 | ↑ +94% |
| Highmark BCBS of PA | Commercial | $263.23 | ↑ +107% |
| Premier Comp Solutions | Worker's Comp | $280.00 | ↑ +120% |
| UPMC Health Plan | CHIP | $330.12 | ↑ +160% |
| Cigna | Commercial | $419.44 | ↑ +230% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
CT heart w/evaluation of calcium without contrast at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $120.00 | $34.78 – $160.00 |
| UPMC Cole | Coudersport | $126.00 | $58.21 – $168.00 |
| UPMC Community Osteopathic | Harrisburg | $127.20 | $19.80 – $330.12 |
| UPMC Hamot | Erie | $120.00 | $62.52 – $118.50 |
| UPMC Hanover | Hanover | $127.20 | $45.56 – $280.00 |
| UPMC Kane | Kane | $124.80 | $62.52 – $308.34 |
| UPMC Lititz | Lititz | $127.20 | $45.56 – $280.00 |
| UPMC Magee | Pittsburgh | $120.00 | $62.52 – $107.43 |