Drainage of urethra abscess 53060 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2,685.60
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.
$4,476.00
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.
$48.90 with Highmark Wholecare (prev Gateway) vs $6,124.10 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $48.90 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $48.90 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $50.05 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $52.44 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $56.08 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $65.61 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $302.37 | ↓ -89% |
| Prime Net | Managed Medicare | $613.21 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $895.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $895.20 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -62% |
| Prime Net | Legacy Commercial | $1,745.64 | ↓ -35% |
| Aetna | ACO | $1,759.07 | ↓ -34% |
| Prime Net | ACO | $1,759.07 | ↓ -34% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,940.05 | ↓ -28% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,940.05 | ↓ -28% |
| Humana | Medicare | $1,959.65 | ↓ -27% |
| Aetna | Medicare | $2,043.91 | ↓ -24% |
| Geisinger | Medicare | $2,057.63 | ↓ -23% |
| Cigna | Medicare | $2,057.63 | ↓ -23% |
| Prime Net | NonGateKeeper | $2,081.34 | ↓ -23% |
| Aetna | Commercial | $2,094.77 | ↓ -22% |
| Prime Net | GateKeeper | $2,094.77 | ↓ -22% |
| United Healthcare | Medicare | $2,096.83 | ↓ -22% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,116.42 | ↓ -21% |
| Keystone Health Plan | Commercial | $2,448.37 | ↓ -9% |
| Capital Blue Cross | CHIP | $2,448.37 | ↓ -9% |
| Capital Blue Cross | Commercial | $2,448.37 | ↓ -9% |
| Wellspan Population Health | PPO | $2,909.40 | ↑ +8% |
| Geisinger | Commercial | $2,930.88 | ↑ +9% |
| UPMC Health Plan | Commercial | $3,133.20 | ↑ +17% |
| Keystone Autism Services | ACAP | $3,135.44 | ↑ +17% |
| Prime Net | FH-Medical Rental | $3,383.86 | ↑ +26% |
| Cigna | Commercial | $3,491.28 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,804.60 | ↑ +42% |
| UPMC Health Plan | CHIP | $4,796.34 | ↑ +79% |
| Highmark BCBS of PA | Community Blue PPO | $5,511.71 | ↑ +105% |
| Highmark BCBS of PA | CHIP - Managed Care | $5,744.91 | ↑ +114% |
| Highmark BCBS of PA | Commercial | $6,124.10 | ↑ +128% |
| 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
Drainage of urethra abscess 53060 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $2,202.00 | $40.42 – $3,303.00 |
| UPMC Community Osteopathic | Harrisburg | $2,685.60 | $48.90 – $4,796.34 |
| UPMC Hanover | Hanover | $2,685.60 | $48.90 – $3,131.10 |
| UPMC Lititz | Lititz | $2,685.60 | $48.90 – $3,148.02 |
| UPMC Magee | Pittsburgh | $2,832.00 | $42.35 – $2,109.25 |
| UPMC Memorial | York | $2,685.60 | $48.90 – $3,142.91 |
| UPMC Somerset | Somerset | $2,685.60 | $42.35 – $1,953.01 |