healthcosts.net
ER Visit (level 3) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$887.40
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.
$1,479.00
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.
$45.50 with AmeriHealth Caritas vs $1,257.15 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 | $45.50 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $62.31 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $73.64 | ↓ -92% |
| United Healthcare Community Plan for Families | PA Medicaid | $74.21 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $77.16 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $82.52 | ↓ -91% |
| PA Health & Wellness | PA Medicaid HMO | $96.54 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $119.67 | ↓ -87% |
| Prime Net | Managed Medicare | $202.62 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $262.23 | ↓ -70% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $262.23 | ↓ -70% |
| Humana | Medicare | $264.88 | ↓ -70% |
| Aetna | Medicare | $276.27 | ↓ -69% |
| Cigna | Medicare | $278.12 | ↓ -69% |
| Geisinger | Medicare | $278.12 | ↓ -69% |
| United Healthcare | Medicare | $283.42 | ↓ -68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $286.07 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $295.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $295.80 | ↓ -67% |
| UPMC Health Plan | CHIP | $355.10 | ↓ -60% |
| Keystone Autism Services | ACAP | $423.81 | ↓ -52% |
| Prime Net | Legacy Commercial | $576.81 | ↓ -35% |
| Aetna | ACO | $581.25 | ↓ -34% |
| Prime Net | ACO | $581.25 | ↓ -34% |
| Prime Net | NonGateKeeper | $687.74 | ↓ -22% |
| Prime Net | GateKeeper | $692.17 | ↓ -22% |
| Aetna | Commercial | $692.17 | ↓ -22% |
| Highmark BCBS of PA | Community Blue PPO | $745.00 | ↓ -16% |
| Highmark BCBS of PA | CHIP - Managed Care | $776.52 | ↓ -12% |
| Capital Blue Cross | CHIP | $809.01 | ↓ -9% |
| Keystone Health Plan | Commercial | $809.01 | ↓ -9% |
| Capital Blue Cross | Commercial | $809.01 | ↓ -9% |
| Highmark BCBS of PA | Commercial | $827.78 | ↓ -7% |
| Wellspan Population Health | PPO | $961.35 | ↑ +8% |
| Geisinger | Commercial | $968.45 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,035.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,118.12 | ↑ +26% |
| Cigna | Commercial | $1,250.00 | ↑ +41% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,257.15 | ↑ +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 3) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $880.20 | $62.31 – $1,173.60 |
| UPMC Passavant-McCandless | Pittsburgh | $763.20 | $62.31 – $1,081.20 |
| UPMC Hamot | Erie | $793.20 | $62.31 – $925.40 |
| UPMC Altoona | Altoona | $709.20 | $79.00 – $945.60 |
| UPMC Bedford | Everett | $429.60 | $59.48 – $644.40 |
| UPMC Cole | Coudersport | $274.20 | $39.46 – $272.94 |
| UPMC Community Osteopathic | Harrisburg | $887.40 | $45.50 – $1,257.15 |
| UPMC Hanover | Hanover | $887.40 | $62.31 – $1,286.73 |