healthcosts.net
ER Visit (level 2) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$570.60
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.
$951.00
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.
$34.91 with AmeriHealth Caritas vs $808.35 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 | $34.91 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $36.28 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $42.87 | ↓ -92% |
| United Healthcare Community Plan for Families | PA Medicaid | $43.20 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $44.92 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $48.04 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $56.20 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $77.89 | ↓ -86% |
| Prime Net | Managed Medicare | $130.29 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $149.98 | ↓ -74% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $149.98 | ↓ -74% |
| Humana | Medicare | $151.49 | ↓ -73% |
| Aetna | Medicare | $158.00 | ↓ -72% |
| Cigna | Medicare | $159.06 | ↓ -72% |
| Geisinger | Medicare | $159.06 | ↓ -72% |
| United Healthcare | Medicare | $162.09 | ↓ -72% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $163.61 | ↓ -71% |
| Keystone Health Plan | Medicare Advantage | $190.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $190.20 | ↓ -67% |
| Keystone Autism Services | ACAP | $242.38 | ↓ -58% |
| UPMC Health Plan | CHIP | $264.38 | ↓ -54% |
| Prime Net | Legacy Commercial | $370.89 | ↓ -35% |
| Aetna | ACO | $373.74 | ↓ -35% |
| Prime Net | ACO | $373.74 | ↓ -35% |
| Highmark BCBS of PA | Community Blue PPO | $426.08 | ↓ -25% |
| Prime Net | NonGateKeeper | $442.21 | ↓ -23% |
| Highmark BCBS of PA | CHIP - Managed Care | $444.11 | ↓ -22% |
| Prime Net | GateKeeper | $445.07 | ↓ -22% |
| Aetna | Commercial | $445.07 | ↓ -22% |
| Highmark BCBS of PA | Commercial | $473.42 | ↓ -17% |
| Capital Blue Cross | CHIP | $520.20 | ↓ -9% |
| Keystone Health Plan | Commercial | $520.20 | ↓ -9% |
| Capital Blue Cross | Commercial | $520.20 | ↓ -9% |
| Wellspan Population Health | PPO | $618.15 | ↑ +8% |
| Geisinger | Commercial | $622.71 | ↑ +9% |
| UPMC Health Plan | Commercial | $665.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $718.96 | ↑ +26% |
| Cigna | Commercial | $750.00 | ↑ +31% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $808.35 | ↑ +42% |
| 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 2) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $424.20 | $36.28 – $600.95 |
| UPMC East | Monroeville | $652.80 | $36.28 – $870.40 |
| UPMC Hamot | Erie | $640.20 | $36.28 – $746.90 |
| UPMC Altoona | Altoona | $496.20 | $35.00 – $661.60 |
| UPMC Bedford | Everett | $325.20 | $34.63 – $487.80 |
| UPMC Cole | Coudersport | $210.00 | $30.27 – $203.78 |
| UPMC Community Osteopathic | Harrisburg | $570.60 | $34.91 – $808.35 |
| UPMC Hanover | Hanover | $570.60 | $36.28 – $827.37 |