Destruction premal lesions 15/> 17004 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$532.80
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.
$888.00
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.
$121.66 with Prime Net vs $1,194.41 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 | $121.66 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $147.82 | ↓ -72% |
| Highmark Wholecare (prev Gateway) | Medicaid | $147.82 | ↓ -72% |
| UPMC Health Plan | Managed Medicaid | $151.31 | ↓ -72% |
| United Healthcare Community Plan for Families | PA Medicaid | $152.47 | ↓ -71% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $158.52 | ↓ -70% |
| Geisinger | Medicaid/CHIP | $169.53 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $177.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $177.60 | ↓ -67% |
| PA Health & Wellness | PA Medicaid HMO | $198.35 | ↓ -63% |
| Prime Net | Legacy Commercial | $346.32 | ↓ -35% |
| Aetna | ACO | $348.98 | ↓ -35% |
| Prime Net | ACO | $348.98 | ↓ -35% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $378.38 | ↓ -29% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $378.38 | ↓ -29% |
| Humana | Medicare | $382.20 | ↓ -28% |
| Aetna | Medicare | $398.63 | ↓ -25% |
| Cigna | Medicare | $401.31 | ↓ -25% |
| Geisinger | Medicare | $401.31 | ↓ -25% |
| United Healthcare | Medicare | $408.95 | ↓ -23% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $412.78 | ↓ -23% |
| Prime Net | NonGateKeeper | $412.92 | ↓ -23% |
| Aetna | Commercial | $415.58 | ↓ -22% |
| Prime Net | GateKeeper | $415.58 | ↓ -22% |
| UPMC Work Partners | Workers Comp | $426.60 | ↓ -20% |
| Keystone Health Plan | Commercial | $485.74 | ↓ -9% |
| Capital Blue Cross | CHIP | $485.74 | ↓ -9% |
| Capital Blue Cross | Commercial | $485.74 | ↓ -9% |
| Wellspan Population Health | PPO | $577.20 | ↑ +8% |
| Geisinger | Commercial | $581.46 | ↑ +9% |
| Keystone Autism Services | ACAP | $611.52 | ↑ +15% |
| UPMC Health Plan | Commercial | $621.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $671.33 | ↑ +26% |
| Cigna | Commercial | $692.64 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $754.80 | ↑ +42% |
| UPMC Health Plan | CHIP | $758.52 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $1,074.98 | ↑ +102% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,120.46 | ↑ +110% |
| Highmark BCBS of PA | Commercial | $1,194.41 | ↑ +124% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Destruction premal lesions 15/> 17004 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $175.20 | $36.04 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $532.80 | $147.82 – $758.52 |
| UPMC Hanover | Hanover | $532.80 | $147.82 – $610.67 |
| UPMC Lititz | Lititz | $532.80 | $147.82 – $613.97 |
| UPMC Magee | Pittsburgh | $2,739.60 | $128.03 – $411.37 |
| UPMC Memorial | York | $532.80 | $147.82 – $612.98 |
| UPMC Presbyterian | Pittsburgh | $1,443.00 | $128.03 – $530.66 |
| UPMC Somerset | Somerset | $532.80 | $128.03 – $407.64 |