Endo cath bile duct s&i at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$525.00
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.
$875.00
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.
$119.88 with Prime Net vs $743.75 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $119.88 | ↓ -77% |
| Aetna | Medicare | $144.38 | ↓ -72% |
| Capital Blue Cross | Medicare Advantage | $175.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $175.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $341.25 | ↓ -35% |
| Aetna | ACO | $343.88 | ↓ -34% |
| Prime Net | ACO | $343.88 | ↓ -34% |
| Premier Comp Solutions | Worker's Comp | $369.30 | ↓ -30% |
| UPMC Work Partners | Workers Comp | $369.30 | ↓ -30% |
| Prime Net | NonGateKeeper | $406.88 | ↓ -22% |
| Aetna | Commercial | $409.50 | ↓ -22% |
| Prime Net | GateKeeper | $409.50 | ↓ -22% |
| Keystone Health Plan | Commercial | $478.62 | ↓ -9% |
| Capital Blue Cross | Commercial | $478.62 | ↓ -9% |
| Capital Blue Cross | CHIP | $478.62 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $481.25 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $481.25 | ↓ -8% |
| Wellspan Population Health | PPO | $568.75 | ↑ +8% |
| UPMC Health Plan | CHIP | $568.85 | ↑ +8% |
| Geisinger | Commercial | $572.95 | ↑ +9% |
| UPMC Health Plan | Commercial | $612.50 | ↑ +17% |
| United Healthcare | Commercial | $644.00 | ↑ +23% |
| Prime Net | FH-Medical Rental | $661.50 | ↑ +26% |
| Cigna | Commercial | $682.50 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $743.75 | ↑ +42% |
Visitor-reported prices
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Endo cath bile duct s&i at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $569.40 | $177.74 – $759.20 |
| UPMC Community Osteopathic | Harrisburg | $525.00 | $175.00 – $781.44 |
| UPMC East | Monroeville | $1,019.40 | $179.43 – $1,359.20 |
| UPMC Hanover | Hanover | $525.00 | $379.49 – $568.85 |
| UPMC Horizon-Greenville | Greenville | $519.60 | $264.13 – $362.63 |
| UPMC Jameson | New Castle | $287.40 | $66.38 – $362.63 |
| UPMC Lititz | Lititz | $525.00 | $66.38 – $568.85 |
| UPMC Magee | Pittsburgh | $1,124.40 | $73.02 – $453.45 |