Debridement bone <= 20 sq cm at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2,320.80
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.
?
What you pay up front if you don't use insurance.
$3,868.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$41.91 with AmeriHealth Caritas vs $4,843.75 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $41.91 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $42.90 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $44.95 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $48.07 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $56.24 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $331.00 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $526.59 | ↓ -77% |
| Prime Net | Managed Medicare | $529.92 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $773.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $773.60 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $793.86 | ↓ -66% |
| Prime Net | Legacy Commercial | $1,508.52 | ↓ -35% |
| Prime Net | ACO | $1,520.12 | ↓ -35% |
| Aetna | ACO | $1,520.12 | ↓ -35% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,534.45 | ↓ -34% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,534.45 | ↓ -34% |
| Humana | Medicare | $1,549.95 | ↓ -33% |
| Aetna | Medicare | $1,616.60 | ↓ -30% |
| Geisinger | Medicare | $1,627.45 | ↓ -30% |
| Cigna | Medicare | $1,627.45 | ↓ -30% |
| United Healthcare | Medicare | $1,658.45 | ↓ -29% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,673.95 | ↓ -28% |
| Prime Net | NonGateKeeper | $1,798.62 | ↓ -23% |
| Prime Net | GateKeeper | $1,810.22 | ↓ -22% |
| Aetna | Commercial | $1,810.22 | ↓ -22% |
| Capital Blue Cross | CHIP | $2,115.80 | ↓ -9% |
| Keystone Health Plan | Commercial | $2,115.80 | ↓ -9% |
| Capital Blue Cross | Commercial | $2,115.80 | ↓ -9% |
| UPMC Health Plan | CHIP | $2,316.72 | ↓ -0% |
| Keystone Autism Services | ACAP | $2,479.92 | ↑ +7% |
| Wellspan Population Health | PPO | $2,514.20 | ↑ +8% |
| Geisinger | Commercial | $2,532.77 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,707.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,924.21 | ↑ +26% |
| Cigna | Commercial | $3,017.04 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,287.80 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $4,359.39 | ↑ +88% |
| Highmark BCBS of PA | CHIP - Managed Care | $4,543.83 | ↑ +96% |
| Highmark BCBS of PA | Commercial | $4,843.75 | ↑ +109% |
| 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
Debridement bone <= 20 sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,656.00 | $33.00 – $2,208.00 |
| UPMC Bedford | Everett | $4,799.40 | $34.65 – $7,199.10 |
| UPMC Cole | Coudersport | $1,353.00 | $34.65 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $2,320.80 | $41.91 – $3,287.80 |
| UPMC Hamot | Erie | $3,124.80 | $36.30 – $2,246.66 |
| UPMC Northwest | Seneca | $2,359.20 | $36.30 – $1,621.93 |
| UPMC Hanover | Hanover | $2,320.80 | $41.91 – $2,476.51 |
| UPMC Horizon-Greenville | Greenville | $2,214.00 | $36.30 – $1,668.28 |