Ercp lithotripsy calculi at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$7,247.40
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.
$12,079.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $17,796.13 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $1,432.72 | ↓ -80% |
| Prime Net | Managed Medicare | $1,654.82 | ↓ -77% |
| UPMC Health Plan | CHIP | $2,297.29 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $2,415.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $2,415.80 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $3,132.02 | ↓ -57% |
| Prime Net | Legacy Commercial | $4,710.81 | ↓ -35% |
| Aetna | ACO | $4,747.05 | ↓ -34% |
| Prime Net | ACO | $4,747.05 | ↓ -34% |
| Cigna | Commercial | $5,035.00 | ↓ -31% |
| Prime Net | NonGateKeeper | $5,616.73 | ↓ -23% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $5,637.63 | ↓ -22% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $5,637.63 | ↓ -22% |
| Aetna | Commercial | $5,652.97 | ↓ -22% |
| Prime Net | GateKeeper | $5,652.97 | ↓ -22% |
| Humana | Medicare | $5,694.58 | ↓ -21% |
| Aetna | Medicare | $5,939.45 | ↓ -18% |
| Cigna | Medicare | $5,979.31 | ↓ -17% |
| Geisinger | Medicare | $5,979.31 | ↓ -17% |
| United Healthcare | Medicare | $6,093.20 | ↓ -16% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $6,150.15 | ↓ -15% |
| Capital Blue Cross | CHIP | $6,607.21 | ↓ -9% |
| Keystone Health Plan | Commercial | $6,607.21 | ↓ -9% |
| Capital Blue Cross | Commercial | $6,607.21 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $6,643.45 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $6,643.45 | ↓ -8% |
| Wellspan Population Health | PPO | $7,851.35 | ↑ +8% |
| Geisinger | Commercial | $7,909.33 | ↑ +9% |
| UPMC Health Plan | Commercial | $8,455.30 | ↑ +17% |
| Keystone Autism Services | ACAP | $9,111.33 | ↑ +26% |
| Prime Net | FH-Medical Rental | $9,131.72 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $10,267.15 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $16,016.58 | ↑ +121% |
| Highmark BCBS of PA | CHIP - Managed Care | $16,694.23 | ↑ +130% |
| Highmark BCBS of PA | Commercial | $17,796.13 | ↑ +146% |
| 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
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Ercp lithotripsy calculi at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,517.80 | $729.80 – $6,129.31 |
| UPMC Community Osteopathic | Harrisburg | $7,247.40 | $1,016.56 – $10,267.15 |
| UPMC East | Monroeville | $3,435.60 | $736.75 – $6,129.31 |
| UPMC Hamot | Erie | $4,144.80 | $729.80 – $8,254.31 |
| UPMC Hanover | Hanover | $7,247.40 | $1,016.56 – $9,098.75 |
| UPMC Jameson | New Castle | $2,490.00 | $742.68 – $7,661.64 |
| UPMC Lititz | Lititz | $7,247.40 | $1,016.56 – $9,147.90 |
| UPMC Magee | Pittsburgh | $3,973.20 | $736.75 – $6,242.82 |