Eeg wo vid ea 12-26hr unmntr at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,773.60
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.
$2,956.00
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.
$152.40 with AmeriHealth Caritas vs $2,512.60 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 | $152.40 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $152.40 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $156.00 | ↓ -91% |
| United Healthcare Community Plan for Families | PA Medicaid | $157.20 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $163.44 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $174.79 | ↓ -90% |
| PA Health & Wellness | PA Medicaid HMO | $204.50 | ↓ -88% |
| Prime Net | Managed Medicare | $404.97 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $502.50 | ↓ -72% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $502.50 | ↓ -72% |
| Humana | Medicare | $507.58 | ↓ -71% |
| Aetna | Medicare | $529.41 | ↓ -70% |
| Cigna | Medicare | $532.96 | ↓ -70% |
| Geisinger | Medicare | $532.96 | ↓ -70% |
| United Healthcare | Medicare | $543.11 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $548.19 | ↓ -69% |
| Keystone Health Plan | Medicare Advantage | $591.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $591.20 | ↓ -67% |
| UPMC Health Plan | CHIP | $702.07 | ↓ -60% |
| Keystone Autism Services | ACAP | $812.13 | ↓ -54% |
| Prime Net | Legacy Commercial | $1,152.84 | ↓ -35% |
| Aetna | ACO | $1,161.71 | ↓ -34% |
| Prime Net | ACO | $1,161.71 | ↓ -34% |
| Prime Net | NonGateKeeper | $1,374.54 | ↓ -23% |
| Aetna | Commercial | $1,383.41 | ↓ -22% |
| Prime Net | GateKeeper | $1,383.41 | ↓ -22% |
| Highmark BCBS of PA | Community Blue PPO | $1,427.62 | ↓ -20% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,488.02 | ↓ -16% |
| Highmark BCBS of PA | Commercial | $1,586.24 | ↓ -11% |
| United Healthcare | Commercial | $1,611.00 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,616.93 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,616.93 | ↓ -9% |
| Capital Blue Cross | CHIP | $1,616.93 | ↓ -9% |
| Wellspan Population Health | PPO | $1,921.40 | ↑ +8% |
| Geisinger | Commercial | $1,935.59 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,069.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,234.74 | ↑ +26% |
| Cigna | Commercial | $2,305.68 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,512.60 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Eeg wo vid ea 12-26hr unmntr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,065.60 | $116.17 – $1,420.80 |
| UPMC Community Osteopathic | Harrisburg | $1,773.60 | $152.40 – $2,512.60 |
| UPMC East | Monroeville | $1,126.20 | $117.28 – $1,501.60 |
| UPMC Hamot | Erie | $1,178.40 | $116.17 – $720.95 |
| UPMC Northwest | Seneca | $1,126.20 | $132.00 – $531.15 |
| UPMC Hanover | Hanover | $1,773.60 | $152.40 – $811.01 |
| UPMC Lititz | Lititz | $1,773.60 | $152.40 – $815.39 |
| UPMC Magee | Pittsburgh | $1,062.60 | $117.28 – $546.33 |