Exc benign feenlm >4.0cm 11446 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$3,515.40
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.
$5,859.00
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.
$150.50 with Highmark Wholecare (prev Gateway) vs $8,556.18 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 | $150.50 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $150.50 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $154.05 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $161.40 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $172.61 | ↓ -95% |
| PA Health & Wellness | PA Medicaid HMO | $201.95 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $741.73 | ↓ -79% |
| United Healthcare Community Plan for Families | PA Medicaid | $759.80 | ↓ -78% |
| Prime Net | Managed Medicare | $802.68 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $1,171.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,171.80 | ↓ -67% |
| Prime Net | Legacy Commercial | $2,285.01 | ↓ -35% |
| Prime Net | ACO | $2,302.59 | ↓ -34% |
| Aetna | ACO | $2,302.59 | ↓ -34% |
| UPMC Health Plan | CHIP | $2,314.48 | ↓ -34% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $2,710.51 | ↓ -23% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $2,710.51 | ↓ -23% |
| Prime Net | NonGateKeeper | $2,724.43 | ↓ -23% |
| Humana | Medicare | $2,737.89 | ↓ -22% |
| Prime Net | GateKeeper | $2,742.01 | ↓ -22% |
| Aetna | Commercial | $2,742.01 | ↓ -22% |
| Aetna | Medicare | $2,855.62 | ↓ -19% |
| Cigna | Medicare | $2,874.78 | ↓ -18% |
| Geisinger | Medicare | $2,874.78 | ↓ -18% |
| United Healthcare | Medicare | $2,929.54 | ↓ -17% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,956.92 | ↓ -16% |
| Capital Blue Cross | CHIP | $3,204.87 | ↓ -9% |
| Capital Blue Cross | Commercial | $3,204.87 | ↓ -9% |
| Keystone Health Plan | Commercial | $3,204.87 | ↓ -9% |
| Wellspan Population Health | PPO | $3,808.35 | ↑ +8% |
| Geisinger | Commercial | $3,836.47 | ↑ +9% |
| UPMC Health Plan | Commercial | $4,101.30 | ↑ +17% |
| Keystone Autism Services | ACAP | $4,380.62 | ↑ +25% |
| Prime Net | FH-Medical Rental | $4,429.40 | ↑ +26% |
| Cigna | Commercial | $4,570.02 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,980.15 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $7,700.59 | ↑ +119% |
| Highmark BCBS of PA | CHIP - Managed Care | $8,026.40 | ↑ +128% |
| Highmark BCBS of PA | Commercial | $8,556.18 | ↑ +143% |
| 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
Exc benign feenlm >4.0cm 11446 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $555.60 | $78.45 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $3,515.40 | $150.50 – $4,980.15 |
| UPMC Hanover | Hanover | $3,515.40 | $150.50 – $4,374.59 |
| UPMC Lititz | Lititz | $3,515.40 | $150.50 – $4,398.21 |
| UPMC Memorial | York | $3,515.40 | $150.50 – $4,391.07 |
| UPMC Presbyterian | Pittsburgh | $5,502.00 | $130.35 – $3,001.48 |
| UPMC Somerset | Somerset | $3,515.40 | $130.35 – $2,728.62 |
| UPMC St. Margaret | Pittsburgh | $3,992.40 | $130.35 – $736.75 |