Drng salivary gland simple 42300 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$3,678.60
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.
$6,131.00
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.
$64.77 with AmeriHealth Caritas vs $5,211.35 with Multiplan — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $64.77 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $64.77 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $66.30 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $69.46 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $74.29 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $86.91 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $280.42 | ↓ -92% |
| Prime Net | Managed Medicare | $839.95 | ↓ -77% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $1,226.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,226.20 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,402.85 | ↓ -62% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,402.85 | ↓ -62% |
| Humana | Medicare | $1,417.02 | ↓ -61% |
| Aetna | Medicare | $1,477.95 | ↓ -60% |
| Geisinger | Medicare | $1,487.87 | ↓ -60% |
| Cigna | Medicare | $1,487.87 | ↓ -60% |
| United Healthcare | Medicare | $1,516.21 | ↓ -59% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,530.38 | ↓ -58% |
| UPMC Health Plan | CHIP | $1,714.22 | ↓ -53% |
| Keystone Autism Services | ACAP | $2,267.23 | ↓ -38% |
| Prime Net | Legacy Commercial | $2,391.09 | ↓ -35% |
| Aetna | ACO | $2,409.48 | ↓ -35% |
| Prime Net | ACO | $2,409.48 | ↓ -35% |
| Prime Net | NonGateKeeper | $2,850.91 | ↓ -23% |
| Aetna | Commercial | $2,869.31 | ↓ -22% |
| Prime Net | GateKeeper | $2,869.31 | ↓ -22% |
| Capital Blue Cross | CHIP | $3,353.66 | ↓ -9% |
| Capital Blue Cross | Commercial | $3,353.66 | ↓ -9% |
| Keystone Health Plan | Commercial | $3,353.66 | ↓ -9% |
| Wellspan Population Health | PPO | $3,985.15 | ↑ +8% |
| Highmark BCBS of PA | Community Blue PPO | $3,985.51 | ↑ +8% |
| Geisinger | Commercial | $4,014.58 | ↑ +9% |
| Highmark BCBS of PA | CHIP - Managed Care | $4,154.14 | ↑ +13% |
| UPMC Health Plan | Commercial | $4,291.70 | ↑ +17% |
| Highmark BCBS of PA | Commercial | $4,428.33 | ↑ +20% |
| Prime Net | FH-Medical Rental | $4,635.04 | ↑ +26% |
| Cigna | Commercial | $4,782.18 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $5,211.35 | ↑ +42% |
| 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
Drng salivary gland simple 42300 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $3,678.60 | $64.77 – $5,211.35 |
| UPMC Hanover | Hanover | $3,678.60 | $64.77 – $2,264.11 |
| UPMC Lititz | Lititz | $3,678.60 | $64.77 – $2,276.34 |
| UPMC Memorial | York | $3,678.60 | $64.77 – $2,272.64 |
| UPMC Somerset | Somerset | $3,678.60 | $56.10 – $1,412.22 |
| Uniontown Hospital | Uniontown | $1,783.50 | $56.10 – $3,123.56 |