Dstrj nulyt agt gnclr nrv at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$5,661.00
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.
$9,435.00
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.
$502.67 with UPMC Work Partners vs $8,019.75 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $502.67 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,027.43 | ↓ -82% |
| Prime Net | Managed Medicare | $1,292.60 | ↓ -77% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,436.40 | ↓ -75% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,849.38 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,849.38 | ↓ -67% |
| Humana | Medicare | $1,868.06 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,887.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,887.00 | ↓ -67% |
| UPMC Health Plan | CHIP | $1,909.32 | ↓ -66% |
| Aetna | Medicare | $1,948.39 | ↓ -66% |
| Geisinger | Medicare | $1,961.46 | ↓ -65% |
| Cigna | Medicare | $1,961.46 | ↓ -65% |
| United Healthcare | Medicare | $1,998.82 | ↓ -65% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,017.50 | ↓ -64% |
| Keystone Autism Services | ACAP | $2,988.90 | ↓ -47% |
| Cigna | Commercial | $3,397.00 | ↓ -40% |
| Prime Net | Legacy Commercial | $3,679.65 | ↓ -35% |
| Aetna | ACO | $3,707.95 | ↓ -35% |
| Prime Net | ACO | $3,707.95 | ↓ -35% |
| Prime Net | NonGateKeeper | $4,387.27 | ↓ -23% |
| Aetna | Commercial | $4,415.58 | ↓ -22% |
| Prime Net | GateKeeper | $4,415.58 | ↓ -22% |
| Capital Blue Cross | Commercial | $5,160.94 | ↓ -9% |
| Keystone Health Plan | Commercial | $5,160.94 | ↓ -9% |
| Capital Blue Cross | CHIP | $5,160.94 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $5,189.25 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $5,189.25 | ↓ -8% |
| Highmark BCBS of PA | Community Blue PPO | $5,254.11 | ↓ -7% |
| Highmark BCBS of PA | CHIP - Managed Care | $5,476.40 | ↓ -3% |
| Highmark BCBS of PA | Commercial | $5,837.87 | ↑ +3% |
| Wellspan Population Health | PPO | $6,132.75 | ↑ +8% |
| Geisinger | Commercial | $6,178.04 | ↑ +9% |
| UPMC Health Plan | Commercial | $6,604.50 | ↑ +17% |
| Prime Net | FH-Medical Rental | $7,132.86 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $8,019.75 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Dstrj nulyt agt gnclr nrv at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $219.60 | $98.03 – $480.33 |
| UPMC Community Osteopathic | Harrisburg | $5,661.00 | $502.67 – $8,019.75 |
| UPMC East | Monroeville | $3,961.20 | $224.43 – $5,281.60 |
| UPMC Northwest | Seneca | $1,400.40 | $480.33 – $2,010.67 |
| UPMC Hanover | Hanover | $5,661.00 | $502.67 – $2,984.77 |
| UPMC Horizon-Greenville | Greenville | $1,033.80 | $432.50 – $2,010.67 |
| UPMC Jameson | New Castle | $1,033.80 | $226.24 – $2,513.34 |
| UPMC Lititz | Lititz | $5,661.00 | $502.67 – $3,000.90 |