Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,620.60
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.
$2,701.00
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.
$29.68 with Highmark BCBS of PA vs $2,295.85 with Multiplan — 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 BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $29.68 | ↓ -98% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $29.68 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $29.98 | ↓ -98% |
| Humana | Medicare | $29.98 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $29.98 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $29.98 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $30.58 | ↓ -98% |
| Aetna | Medicare | $31.27 | ↓ -98% |
| Cigna | Medicare | $31.48 | ↓ -98% |
| Geisinger | Medicare | $31.48 | ↓ -98% |
| United Healthcare | Medicare | $32.08 | ↓ -98% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $32.38 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $32.98 | ↓ -98% |
| UPMC Health Plan | CHIP | $36.87 | ↓ -98% |
| Cigna | Commercial | $38.41 | ↓ -98% |
| Keystone Autism Services | ACAP | $47.97 | ↓ -97% |
| Highmark BCBS of PA | Community Blue PPO | $84.32 | ↓ -95% |
| Highmark BCBS of PA | CHIP - Managed Care | $87.89 | ↓ -95% |
| Highmark BCBS of PA | Commercial | $93.69 | ↓ -94% |
| United Healthcare | Commercial | $191.30 | ↓ -88% |
| Prime Net | Managed Medicare | $370.04 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $540.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $540.20 | ↓ -67% |
| Capital Blue Cross | CHIP | $867.02 | ↓ -47% |
| Keystone Health Plan | Commercial | $867.02 | ↓ -47% |
| Capital Blue Cross | Commercial | $867.02 | ↓ -47% |
| Prime Net | Legacy Commercial | $1,053.39 | ↓ -35% |
| Aetna | ACO | $1,061.49 | ↓ -35% |
| Prime Net | ACO | $1,061.49 | ↓ -35% |
| UPMC Work Partners | Workers Comp | $1,099.85 | ↓ -32% |
| Prime Net | NonGateKeeper | $1,255.96 | ↓ -23% |
| Aetna | Commercial | $1,264.07 | ↓ -22% |
| Prime Net | GateKeeper | $1,264.07 | ↓ -22% |
| Wellspan Population Health | PPO | $1,755.65 | ↑ +8% |
| Geisinger | Commercial | $1,768.61 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,890.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,041.96 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,295.85 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $5,716.80 | $29.98 – $7,622.40 |
| UPMC Community Osteopathic | Harrisburg | $1,620.60 | $29.68 – $2,295.85 |
| UPMC Hanover | Hanover | $1,620.60 | $29.68 – $47.97 |
| UPMC Lititz | Lititz | $1,620.60 | $29.68 – $47.97 |
| UPMC Memorial | York | $1,620.60 | $15.92 – $47.97 |
| UPMC Somerset | Somerset | $1,620.60 | $19.34 – $29.98 |
| Uniontown Hospital | Uniontown | $29,347.50 | $32.87 – $76.59 |
| UPMC St. Margaret | Pittsburgh | not published | $18.93 – $32.98 |