Exam plvc w/anes othr thn lcl at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
not published by hospital
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.
not published by hospital
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.
$50.16 with Highmark Wholecare (prev Gateway) vs $9,505.30 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $50.16 | — |
| UPMC Health Plan | Managed Medicaid | $51.35 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $53.33 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $53.80 | — |
| Geisinger | Medicaid/CHIP | $57.54 | — |
| PA Health & Wellness | PA Medicaid HMO | $67.32 | — |
| UPMC Work Partners | Workers Comp | $89.89 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $131.00 | — |
| UPMC Health Plan | CHIP | $2,317.22 | — |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $3,011.18 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $3,011.18 | — |
| Humana | Medicare | $3,041.60 | — |
| Aetna | Medicare | $3,172.39 | — |
| Geisinger | Medicare | $3,193.68 | — |
| Cigna | Medicare | $3,193.68 | — |
| United Healthcare | Medicare | $3,254.51 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,284.93 | — |
| Keystone Autism Services | ACAP | $4,866.56 | — |
| Cigna | Commercial | $5,035.00 | — |
| Highmark BCBS of PA | Community Blue PPO | $8,554.80 | — |
| Highmark BCBS of PA | CHIP - Managed Care | $8,916.75 | — |
| Highmark BCBS of PA | Commercial | $9,505.30 | — |
| 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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Exam plvc w/anes othr thn lcl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $200.40 | $41.48 – $1,041.88 |
| UPMC Magee | Pittsburgh | $936.00 | $43.45 – $3,273.80 |
| Uniontown Hospital | Uniontown | $465.00 | $43.45 – $6,516.82 |
| UPMC Altoona | Altoona | not published | $39.50 – $3,273.80 |
| UPMC Bedford | Everett | not published | $41.48 – $3,273.80 |
| UPMC East | Monroeville | not published | $43.45 – $3,334.43 |
| UPMC Wellsboro | Wellsboro | not published | $43.45 – $128.00 |
| WellSpan Chambersburg Hospital | Chambersburg | not published | $970.00 – $14,622.99 |