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ER Visit (level 5, high severity) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,828.80
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.
$3,048.00
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.
$65.00 with AmeriHealth Caritas vs $2,590.80 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 | $65.00 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $152.61 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $180.36 | ↓ -90% |
| United Healthcare Community Plan for Families | PA Medicaid | $181.75 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $188.96 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $202.09 | ↓ -89% |
| PA Health & Wellness | PA Medicaid HMO | $236.44 | ↓ -87% |
| UPMC Work Partners | Workers Comp | $270.19 | ↓ -85% |
| Prime Net | Managed Medicare | $417.58 | ↓ -77% |
| UPMC Health Plan | CHIP | $547.01 | ↓ -70% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $580.63 | ↓ -68% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $580.63 | ↓ -68% |
| Humana | Medicare | $586.50 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $609.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $609.60 | ↓ -67% |
| Aetna | Medicare | $611.72 | ↓ -67% |
| Cigna | Medicare | $615.83 | ↓ -66% |
| Geisinger | Medicare | $615.83 | ↓ -66% |
| United Healthcare | Medicare | $627.55 | ↓ -66% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $633.42 | ↓ -65% |
| Keystone Autism Services | ACAP | $938.40 | ↓ -49% |
| Prime Net | Legacy Commercial | $1,188.72 | ↓ -35% |
| Aetna | ACO | $1,197.86 | ↓ -35% |
| Prime Net | ACO | $1,197.86 | ↓ -35% |
| Prime Net | NonGateKeeper | $1,417.32 | ↓ -23% |
| Prime Net | GateKeeper | $1,426.46 | ↓ -22% |
| Aetna | Commercial | $1,426.46 | ↓ -22% |
| Highmark BCBS of PA | Community Blue PPO | $1,649.59 | ↓ -10% |
| Capital Blue Cross | CHIP | $1,667.26 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,667.26 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,667.26 | ↓ -9% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,719.38 | ↓ -6% |
| Highmark BCBS of PA | Commercial | $1,832.87 | ↑ +0% |
| Cigna | Commercial | $1,850.00 | ↑ +1% |
| Wellspan Population Health | PPO | $1,981.20 | ↑ +8% |
| Geisinger | Commercial | $1,995.83 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,133.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,304.29 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,590.80 | ↑ +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 5, high severity) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $1,371.00 | $152.61 – $1,828.00 |
| UPMC Passavant-McCandless | Pittsburgh | $1,798.20 | $152.61 – $2,547.45 |
| UPMC Hamot | Erie | $2,165.40 | $152.61 – $2,526.30 |
| UPMC Altoona | Altoona | $1,449.00 | $174.21 – $1,932.00 |
| UPMC Bedford | Everett | $903.60 | $145.68 – $1,355.40 |
| UPMC Cole | Coudersport | $630.00 | $56.38 – $553.93 |
| UPMC Community Osteopathic | Harrisburg | $1,828.80 | $65.00 – $645.31 |
| UPMC Hanover | Hanover | $1,828.80 | $152.61 – $2,651.76 |