healthcosts.net
ER Visit (level 1, minor) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$391.20
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.
$652.00
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.
$21.05 with AmeriHealth Caritas vs $750.00 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 | $21.05 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $50.90 | ↓ -87% |
| United Healthcare Community Plan for Families | PA Medicaid | $60.00 | ↓ -85% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $83.39 | ↓ -79% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $83.39 | ↓ -79% |
| Humana | Medicare | $84.23 | ↓ -78% |
| Aetna | Medicare | $87.85 | ↓ -78% |
| Cigna | Medicare | $88.44 | ↓ -77% |
| Geisinger | Medicare | $88.44 | ↓ -77% |
| Prime Net | Managed Medicare | $89.32 | ↓ -77% |
| United Healthcare | Medicare | $90.13 | ↓ -77% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $90.97 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $130.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $130.40 | ↓ -67% |
| Keystone Autism Services | ACAP | $134.77 | ↓ -66% |
| UPMC Health Plan | CHIP | $176.68 | ↓ -55% |
| Highmark BCBS of PA | Community Blue PPO | $236.91 | ↓ -39% |
| Highmark BCBS of PA | CHIP - Managed Care | $246.93 | ↓ -37% |
| Prime Net | Legacy Commercial | $254.28 | ↓ -35% |
| Aetna | ACO | $256.24 | ↓ -34% |
| Prime Net | ACO | $256.24 | ↓ -34% |
| Highmark BCBS of PA | Commercial | $263.23 | ↓ -33% |
| Prime Net | NonGateKeeper | $303.18 | ↓ -23% |
| Prime Net | GateKeeper | $305.14 | ↓ -22% |
| Aetna | Commercial | $305.14 | ↓ -22% |
| Capital Blue Cross | CHIP | $356.64 | ↓ -9% |
| Keystone Health Plan | Commercial | $356.64 | ↓ -9% |
| Capital Blue Cross | Commercial | $356.64 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $358.60 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $358.60 | ↓ -8% |
| Wellspan Population Health | PPO | $423.80 | ↑ +8% |
| Geisinger | Commercial | $426.93 | ↑ +9% |
| UPMC Health Plan | Commercial | $456.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $492.91 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $554.20 | ↑ +42% |
| Cigna | Commercial | $750.00 | ↑ +92% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
ER Visit (level 1, minor) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $183.60 | $51.60 – $260.10 |
| UPMC East | Monroeville | $260.40 | $51.60 – $347.20 |
| UPMC Hamot | Erie | $384.60 | $51.60 – $448.70 |
| UPMC Altoona | Altoona | $374.40 | $21.00 – $499.20 |
| UPMC Bedford | Everett | $215.40 | $30.29 – $323.10 |
| UPMC Cole | Coudersport | $136.20 | $18.26 – $103.74 |
| UPMC Community Osteopathic | Harrisburg | $391.20 | $21.05 – $554.20 |
| UPMC Hanover | Hanover | $391.20 | $53.65 – $567.24 |