healthcosts.net
Drain finger abscess;simple 26010 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$265.20
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.
$442.00
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.
$33.66 with Highmark Wholecare (prev Gateway) vs $1,016.56 with United Healthcare Community Plan for Families — 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $33.66 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $33.66 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $34.45 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $36.09 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $38.60 | ↓ -85% |
| PA Health & Wellness | PA Medicaid HMO | $45.16 | ↓ -83% |
| Prime Net | Managed Medicare | $60.55 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $88.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $88.40 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $151.31 | ↓ -43% |
| Prime Net | Legacy Commercial | $172.38 | ↓ -35% |
| Prime Net | ACO | $173.71 | ↓ -34% |
| Aetna | ACO | $173.71 | ↓ -34% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $188.18 | ↓ -29% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $188.18 | ↓ -29% |
| Humana | Medicare | $190.08 | ↓ -28% |
| Aetna | Medicare | $198.25 | ↓ -25% |
| Cigna | Medicare | $199.58 | ↓ -25% |
| Geisinger | Medicare | $199.58 | ↓ -25% |
| United Healthcare | Medicare | $203.39 | ↓ -23% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $205.29 | ↓ -23% |
| Prime Net | NonGateKeeper | $205.53 | ↓ -23% |
| Prime Net | GateKeeper | $206.86 | ↓ -22% |
| Aetna | Commercial | $206.86 | ↓ -22% |
| UPMC Health Plan | CHIP | $212.97 | ↓ -20% |
| Keystone Health Plan | Commercial | $241.77 | ↓ -9% |
| Capital Blue Cross | Commercial | $241.77 | ↓ -9% |
| Capital Blue Cross | CHIP | $241.77 | ↓ -9% |
| Wellspan Population Health | PPO | $287.30 | ↑ +8% |
| Geisinger | Commercial | $289.42 | ↑ +9% |
| Keystone Autism Services | ACAP | $304.13 | ↑ +15% |
| UPMC Health Plan | Commercial | $309.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $334.15 | ↑ +26% |
| Cigna | Commercial | $344.76 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $375.70 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $534.62 | ↑ +102% |
| Highmark BCBS of PA | CHIP - Managed Care | $557.24 | ↑ +110% |
| Highmark BCBS of PA | Commercial | $594.02 | ↑ +124% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +283% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Drain finger abscess;simple 26010 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $366.00 | $26.50 – $488.00 |
| UPMC Bedford | Everett | $459.60 | $27.82 – $689.40 |
| UPMC Northwest | Seneca | $194.40 | $29.15 – $275.40 |
| UPMC Mercy | Pittsburgh | $484.20 | $29.15 – $726.30 |
| UPMC Muncy | Muncy | $589.80 | $29.15 – $993.28 |
| UPMC Passavant-McCandless | Pittsburgh | $478.20 | $29.15 – $677.45 |
| UPMC Presbyterian | Pittsburgh | $451.20 | $29.15 – $931.20 |
| UPMC Somerset | Somerset | $265.20 | $29.15 – $892.40 |