Dup scan/ue art/graft/bilat/comp 93930 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$819.60
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.
$1,366.00
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.
$156.34 with United Healthcare Community Plan for Families vs $1,224.77 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $156.34 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $179.78 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicaid | $179.78 | ↓ -78% |
| UPMC Health Plan | Managed Medicaid | $184.03 | ↓ -78% |
| Prime Net | Managed Medicare | $187.14 | ↓ -77% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $192.80 | ↓ -76% |
| Geisinger | Medicaid/CHIP | $206.20 | ↓ -75% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $228.92 | ↓ -72% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $228.92 | ↓ -72% |
| Humana | Medicare | $231.23 | ↓ -72% |
| Aetna | Medicare | $241.17 | ↓ -71% |
| PA Health & Wellness | PA Medicaid HMO | $241.25 | ↓ -71% |
| Cigna | Medicare | $242.79 | ↓ -70% |
| Geisinger | Medicare | $242.79 | ↓ -70% |
| United Healthcare | Medicare | $247.42 | ↓ -70% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $249.73 | ↓ -70% |
| Keystone Health Plan | Medicare Advantage | $273.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $273.20 | ↓ -67% |
| Keystone Autism Services | ACAP | $369.97 | ↓ -55% |
| UPMC Work Partners | Workers Comp | $401.65 | ↓ -51% |
| UPMC Health Plan | CHIP | $442.51 | ↓ -46% |
| Prime Net | Legacy Commercial | $532.74 | ↓ -35% |
| Prime Net | ACO | $536.84 | ↓ -34% |
| Aetna | ACO | $536.84 | ↓ -34% |
| Prime Net | NonGateKeeper | $635.19 | ↓ -23% |
| Prime Net | GateKeeper | $639.29 | ↓ -22% |
| Aetna | Commercial | $639.29 | ↓ -22% |
| Highmark BCBS of PA | Community Blue PPO | $650.36 | ↓ -21% |
| Highmark BCBS of PA | CHIP - Managed Care | $677.87 | ↓ -17% |
| Highmark BCBS of PA | Commercial | $722.62 | ↓ -12% |
| Keystone Health Plan | Commercial | $747.20 | ↓ -9% |
| Capital Blue Cross | Commercial | $747.20 | ↓ -9% |
| Capital Blue Cross | CHIP | $747.20 | ↓ -9% |
| United Healthcare | Commercial | $801.00 | ↓ -2% |
| Wellspan Population Health | PPO | $887.90 | ↑ +8% |
| Geisinger | Commercial | $894.46 | ↑ +9% |
| UPMC Health Plan | Commercial | $956.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,032.70 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,161.10 | ↑ +42% |
| Cigna | Commercial | $1,224.77 | ↑ +49% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Dup scan/ue art/graft/bilat/comp 93930 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $887.40 | $119.34 – $1,183.20 |
| UPMC Bedford | Everett | $1,008.00 | $83.15 – $1,512.00 |
| UPMC Cole | Coudersport | $509.40 | $148.64 – $679.20 |
| UPMC Community Osteopathic | Harrisburg | $819.60 | $156.34 – $1,161.10 |
| UPMC East | Monroeville | $885.60 | $147.62 – $1,180.80 |
| UPMC Hamot | Erie | $1,007.40 | $146.23 – $425.48 |
| UPMC Northwest | Seneca | $490.20 | $155.72 – $389.47 |
| UPMC Hanover | Hanover | $819.60 | $156.34 – $407.58 |