Dactinomycin 0.5 mg intravenous solution at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,624.80
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.
$2,708.00
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.
$68.50 with Prime Net vs $1,026.10 with Highmark BCBS of PA — 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 | $68.50 | ↓ -96% |
| Keystone Health Plan | Medicare Advantage | $100.00 | ↓ -94% |
| Capital Blue Cross | Medicare Advantage | $100.00 | ↓ -94% |
| Keystone Health Plan | Commercial | $160.50 | ↓ -90% |
| Capital Blue Cross | CHIP | $160.50 | ↓ -90% |
| Capital Blue Cross | Commercial | $160.50 | ↓ -90% |
| Prime Net | Legacy Commercial | $195.00 | ↓ -88% |
| Aetna | ACO | $196.50 | ↓ -88% |
| Prime Net | ACO | $196.50 | ↓ -88% |
| UPMC Work Partners | Workers Comp | $203.60 | ↓ -87% |
| Prime Net | NonGateKeeper | $232.50 | ↓ -86% |
| Aetna | Commercial | $234.00 | ↓ -86% |
| Prime Net | GateKeeper | $234.00 | ↓ -86% |
| United Healthcare | Commercial | $308.00 | ↓ -81% |
| Wellspan Population Health | PPO | $325.00 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $325.06 | ↓ -80% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $325.06 | ↓ -80% |
| Geisinger | Commercial | $327.40 | ↓ -80% |
| PA Health & Wellness | PA Medicaid HMO | $328.34 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $328.34 | ↓ -80% |
| Humana | Medicare | $328.34 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $328.34 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicaid | $334.90 | ↓ -79% |
| Aetna | Medicare | $342.46 | ↓ -79% |
| Cigna | Medicare | $344.76 | ↓ -79% |
| Geisinger | Medicare | $344.76 | ↓ -79% |
| UPMC Health Plan | Commercial | $350.00 | ↓ -78% |
| United Healthcare | Medicare | $351.32 | ↓ -78% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $354.61 | ↓ -78% |
| UPMC Health Plan | Managed Medicaid | $361.17 | ↓ -78% |
| Prime Net | FH-Medical Rental | $378.00 | ↓ -77% |
| UPMC Health Plan | CHIP | $403.86 | ↓ -75% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $425.00 | ↓ -74% |
| Keystone Autism Services | ACAP | $525.34 | ↓ -68% |
| Highmark BCBS of PA | Community Blue PPO | $923.49 | ↓ -43% |
| Cigna | Commercial | $943.15 | ↓ -42% |
| Highmark BCBS of PA | CHIP - Managed Care | $962.56 | ↓ -41% |
| Highmark BCBS of PA | Commercial | $1,026.10 | ↓ -37% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Dactinomycin 0.5 mg intravenous solution at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $808.20 | $25.35 – $1,077.60 |
| UPMC Community Osteopathic | Harrisburg | $1,624.80 | $42.22 – $425.00 |
| UPMC Hanover | Hanover | $1,624.80 | $325.06 – $525.34 |
| UPMC Lititz | Lititz | $1,624.80 | $325.06 – $525.34 |
| UPMC Magee | Pittsburgh | $880.80 | $25.60 – $354.61 |
| UPMC Memorial | York | $1,624.80 | $20.66 – $525.34 |
| UPMC Muncy | Muncy | $2,879.40 | $328.34 – $361.17 |
| UPMC Passavant-McCandless | Pittsburgh | $166.20 | $25.60 – $361.17 |