Exc tr-ext mal+marg tal >4 cm 11606 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$3,121.20
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.
$5,202.00
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.
$312.42 with AmeriHealth Caritas vs $5,035.00 with Cigna — 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 | $312.42 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $312.42 | ↓ -90% |
| UPMC Health Plan | Managed Medicaid | $319.80 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $335.05 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $358.32 | ↓ -89% |
| PA Health & Wellness | PA Medicaid HMO | $419.23 | ↓ -87% |
| Prime Net | Managed Medicare | $712.67 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $923.05 | ↓ -70% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,040.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,040.40 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,534.45 | ↓ -51% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,534.45 | ↓ -51% |
| Humana | Medicare | $1,549.95 | ↓ -50% |
| Aetna | Medicare | $1,616.60 | ↓ -48% |
| Geisinger | Medicare | $1,627.45 | ↓ -48% |
| Cigna | Medicare | $1,627.45 | ↓ -48% |
| United Healthcare | Medicare | $1,658.45 | ↓ -47% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,673.95 | ↓ -46% |
| Prime Net | Legacy Commercial | $2,028.78 | ↓ -35% |
| Aetna | ACO | $2,044.39 | ↓ -34% |
| Prime Net | ACO | $2,044.39 | ↓ -34% |
| UPMC Health Plan | CHIP | $2,299.47 | ↓ -26% |
| Prime Net | NonGateKeeper | $2,418.93 | ↓ -23% |
| Prime Net | GateKeeper | $2,434.54 | ↓ -22% |
| Aetna | Commercial | $2,434.54 | ↓ -22% |
| Keystone Autism Services | ACAP | $2,479.92 | ↓ -21% |
| Capital Blue Cross | Commercial | $2,845.49 | ↓ -9% |
| Keystone Health Plan | Commercial | $2,845.49 | ↓ -9% |
| Capital Blue Cross | CHIP | $2,845.49 | ↓ -9% |
| Wellspan Population Health | PPO | $3,381.30 | ↑ +8% |
| Geisinger | Commercial | $3,406.27 | ↑ +9% |
| UPMC Health Plan | Commercial | $3,641.40 | ↑ +17% |
| United Healthcare | Commercial | $3,828.67 | ↑ +23% |
| Prime Net | FH-Medical Rental | $3,932.71 | ↑ +26% |
| Highmark BCBS of PA | Community Blue PPO | $4,359.39 | ↑ +40% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,421.70 | ↑ +42% |
| Highmark BCBS of PA | CHIP - Managed Care | $4,543.83 | ↑ +46% |
| Highmark BCBS of PA | Commercial | $4,843.75 | ↑ +55% |
| Cigna | Commercial | $5,035.00 | ↑ +61% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc tr-ext mal+marg tal >4 cm 11606 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $2,616.60 | $62.92 – $1,041.88 |
| UPMC Hanover | Hanover | $3,121.20 | $312.42 – $2,476.51 |
| UPMC Lititz | Lititz | $3,121.20 | $312.42 – $2,489.89 |
| UPMC Magee | Pittsburgh | $3,247.80 | $270.60 – $1,668.28 |
| UPMC Presbyterian | Pittsburgh | $3,835.20 | $270.60 – $1,699.17 |
| UPMC St. Margaret | Pittsburgh | $3,448.20 | $270.60 – $1,699.17 |
| UPMC Williamsport | Williamsport | $1,105.20 | $270.60 – $1,652.83 |
| Uniontown Hospital | Uniontown | $986.67 | $205.80 – $3,324.90 |