Exc benign tal 0.5 < cm 11400 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,341.60
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.
$2,236.00
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.
$47.62 with AmeriHealth Caritas vs $2,103.41 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $47.62 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $47.62 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $48.75 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $51.08 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $54.62 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $63.91 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $143.44 | ↓ -89% |
| Prime Net | Managed Medicare | $306.33 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $447.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $447.20 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $666.34 | ↓ -50% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $666.34 | ↓ -50% |
| Humana | Medicare | $673.07 | ↓ -50% |
| Aetna | Medicare | $702.01 | ↓ -48% |
| Cigna | Medicare | $706.72 | ↓ -47% |
| Geisinger | Medicare | $706.72 | ↓ -47% |
| United Healthcare | Medicare | $720.18 | ↓ -46% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $726.92 | ↓ -46% |
| Prime Net | Legacy Commercial | $872.04 | ↓ -35% |
| Aetna | ACO | $878.75 | ↓ -34% |
| Prime Net | ACO | $878.75 | ↓ -34% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -24% |
| Prime Net | NonGateKeeper | $1,039.74 | ↓ -23% |
| Aetna | Commercial | $1,046.45 | ↓ -22% |
| Prime Net | GateKeeper | $1,046.45 | ↓ -22% |
| UPMC Health Plan | CHIP | $1,065.01 | ↓ -21% |
| Keystone Autism Services | ACAP | $1,076.91 | ↓ -20% |
| Capital Blue Cross | CHIP | $1,223.09 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,223.09 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,223.09 | ↓ -9% |
| Wellspan Population Health | PPO | $1,453.40 | ↑ +8% |
| Geisinger | Commercial | $1,464.13 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,565.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,690.42 | ↑ +26% |
| Cigna | Commercial | $1,744.08 | ↑ +30% |
| Highmark BCBS of PA | Community Blue PPO | $1,893.08 | ↑ +41% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,900.60 | ↑ +42% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,973.17 | ↑ +47% |
| Highmark BCBS of PA | Commercial | $2,103.41 | ↑ +57% |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Exc benign tal 0.5 < cm 11400 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,157.60 | $37.50 – $2,876.80 |
| UPMC Cole | Coudersport | $94.20 | $20.51 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $1,341.60 | $47.62 – $1,286.90 |
| UPMC Hanover | Hanover | $1,341.60 | $47.62 – $1,075.42 |
| UPMC Kane | Kane | $496.20 | $41.25 – $533.72 |
| UPMC Lititz | Lititz | $1,341.60 | $47.62 – $1,081.23 |
| UPMC Magee | Pittsburgh | $1,930.20 | $41.25 – $724.45 |
| UPMC Memorial | York | $1,341.60 | $47.62 – $1,079.47 |