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Diagnostic Mammogram (one breast) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$243.60
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.
$406.00
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.
$19.45 with Prime Net vs $479.38 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 | $19.45 | ↓ -92% |
| Aetna | Medicare | $23.43 | ↓ -90% |
| Capital Blue Cross | Medicare Advantage | $28.40 | ↓ -88% |
| Keystone Health Plan | Medicare Advantage | $28.40 | ↓ -88% |
| Prime Net | Legacy Commercial | $55.38 | ↓ -77% |
| Aetna | ACO | $55.81 | ↓ -77% |
| Prime Net | ACO | $55.81 | ↓ -77% |
| Prime Net | NonGateKeeper | $66.03 | ↓ -73% |
| Aetna | Commercial | $66.46 | ↓ -73% |
| Prime Net | GateKeeper | $66.46 | ↓ -73% |
| Capital Blue Cross | CHIP | $77.67 | ↓ -68% |
| Capital Blue Cross | Commercial | $77.67 | ↓ -68% |
| Keystone Health Plan | Commercial | $77.67 | ↓ -68% |
| Wellspan Population Health | PPO | $92.30 | ↓ -62% |
| Geisinger | Commercial | $92.98 | ↓ -62% |
| United Healthcare Community Plan for Families | PA Medicaid | $93.02 | ↓ -62% |
| UPMC Health Plan | Commercial | $99.40 | ↓ -59% |
| United Healthcare | Commercial | $104.51 | ↓ -57% |
| Prime Net | FH-Medical Rental | $107.35 | ↓ -56% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $120.70 | ↓ -50% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $130.06 | ↓ -47% |
| Highmark Wholecare (prev Gateway) | Medicaid | $130.06 | ↓ -47% |
| UPMC Health Plan | Managed Medicaid | $133.13 | ↓ -45% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $139.48 | ↓ -43% |
| Geisinger | Medicaid/CHIP | $149.17 | ↓ -39% |
| PA Health & Wellness | PA Medicaid HMO | $174.53 | ↓ -28% |
| UPMC Health Plan | CHIP | $364.39 | ↑ +50% |
| Cigna | Commercial | $479.38 | ↑ +97% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Diagnostic Mammogram (one breast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $336.60 | $58.27 – $448.80 |
| UPMC Passavant-McCandless | Pittsburgh | $427.20 | $58.27 – $605.20 |
| UPMC Hamot | Erie | $478.80 | $57.72 – $558.60 |
| UPMC Altoona | Altoona | $475.80 | $57.72 – $634.40 |
| UPMC Bedford | Everett | $502.20 | $107.53 – $753.30 |
| UPMC Cole | Coudersport | $360.00 | $107.53 – $480.00 |
| UPMC Community Osteopathic | Harrisburg | $349.80 | $28.40 – $364.39 |
| UPMC Hanover | Hanover | $243.60 | $26.98 – $479.38 |