Electrophysiology evaluation at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$3,064.20
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.
$5,107.00
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.
$638.73 with AmeriHealth Caritas vs $17,298.00 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $638.73 | ↓ -79% |
| Prime Net | Managed Medicare | $699.66 | ↓ -77% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,021.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,021.40 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,149.72 | ↓ -62% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,149.72 | ↓ -62% |
| Humana | Medicare | $1,161.33 | ↓ -62% |
| Aetna | Medicare | $1,211.27 | ↓ -60% |
| Geisinger | Medicare | $1,219.40 | ↓ -60% |
| Cigna | Medicare | $1,219.40 | ↓ -60% |
| United Healthcare | Medicare | $1,242.62 | ↓ -59% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,254.24 | ↓ -59% |
| UPMC Health Plan | CHIP | $1,486.91 | ↓ -51% |
| UPMC Work Partners | Workers Comp | $1,754.16 | ↓ -43% |
| Keystone Autism Services | ACAP | $1,858.13 | ↓ -39% |
| Prime Net | Legacy Commercial | $1,991.73 | ↓ -35% |
| Aetna | ACO | $2,007.05 | ↓ -35% |
| Prime Net | ACO | $2,007.05 | ↓ -35% |
| Prime Net | NonGateKeeper | $2,374.76 | ↓ -22% |
| Prime Net | GateKeeper | $2,390.08 | ↓ -22% |
| Aetna | Commercial | $2,390.08 | ↓ -22% |
| Keystone Health Plan | Commercial | $2,793.53 | ↓ -9% |
| Capital Blue Cross | Commercial | $2,793.53 | ↓ -9% |
| Capital Blue Cross | CHIP | $2,793.53 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $2,808.85 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $2,808.85 | ↓ -8% |
| Highmark BCBS of PA | Community Blue PPO | $3,266.36 | ↑ +7% |
| Wellspan Population Health | PPO | $3,319.55 | ↑ +8% |
| Geisinger | Commercial | $3,344.06 | ↑ +9% |
| Highmark BCBS of PA | CHIP - Managed Care | $3,404.56 | ↑ +11% |
| UPMC Health Plan | Commercial | $3,574.90 | ↑ +17% |
| Highmark BCBS of PA | Commercial | $3,629.27 | ↑ +18% |
| Prime Net | FH-Medical Rental | $3,860.89 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,340.95 | ↑ +42% |
| Cigna | Commercial | $17,298.00 | ↑ +465% |
| 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
Electrophysiology evaluation at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,350.20 | $476.95 – $3,133.60 |
| UPMC Community Osteopathic | Harrisburg | $3,064.20 | $1,016.56 – $4,340.95 |
| UPMC Hamot | Erie | $5,272.80 | $476.95 – $1,824.38 |
| UPMC Hanover | Hanover | $3,064.20 | $1,016.56 – $1,855.55 |
| UPMC Lititz | Lititz | $3,064.20 | $1,016.56 – $1,865.58 |
| UPMC Memorial | York | $3,064.20 | $388.73 – $1,862.56 |
| UPMC Mercy | Pittsburgh | $1,368.00 | $476.95 – $1,319.76 |
| UPMC Passavant-McCandless | Pittsburgh | $1,735.80 | $481.49 – $2,121.37 |