Fibrinolytic plasminogen xcpt antgnc asa at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$33.00
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.
$55.00
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.
$5.00 with AmeriHealth Caritas vs $46.75 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $5.00 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $6.35 | ↓ -81% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $6.46 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $6.46 | ↓ -80% |
| UPMC Health Plan | Managed Medicaid | $6.50 | ↓ -80% |
| Humana | Medicare | $6.53 | ↓ -80% |
| United Healthcare Community Plan for Families | PA Medicaid | $6.55 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $6.76 | ↓ -80% |
| Aetna | Medicare | $6.81 | ↓ -79% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $6.81 | ↓ -79% |
| Geisinger | Medicare | $6.86 | ↓ -79% |
| Cigna | Medicare | $6.86 | ↓ -79% |
| United Healthcare | Medicare | $6.99 | ↓ -79% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $7.05 | ↓ -79% |
| Geisinger | Medicaid/CHIP | $7.28 | ↓ -78% |
| Prime Net | Managed Medicare | $7.54 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $8.52 | ↓ -74% |
| Keystone Autism Services | ACAP | $10.45 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $11.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $11.00 | ↓ -67% |
| Cigna | Commercial | $16.96 | ↓ -49% |
| Highmark BCBS of PA | Community Blue PPO | $18.37 | ↓ -44% |
| Highmark BCBS of PA | CHIP - Managed Care | $19.14 | ↓ -42% |
| Highmark BCBS of PA | Commercial | $20.41 | ↓ -38% |
| Prime Net | Legacy Commercial | $21.45 | ↓ -35% |
| Aetna | ACO | $21.61 | ↓ -35% |
| Prime Net | ACO | $21.61 | ↓ -35% |
| United Healthcare | Commercial | $25.46 | ↓ -23% |
| Prime Net | NonGateKeeper | $25.57 | ↓ -23% |
| Aetna | Commercial | $25.74 | ↓ -22% |
| Prime Net | GateKeeper | $25.74 | ↓ -22% |
| Capital Blue Cross | Commercial | $30.09 | ↓ -9% |
| Capital Blue Cross | CHIP | $30.09 | ↓ -9% |
| Keystone Health Plan | Commercial | $30.09 | ↓ -9% |
| Wellspan Population Health | PPO | $35.75 | ↑ +8% |
| Geisinger | Commercial | $36.01 | ↑ +9% |
| UPMC Health Plan | Commercial | $38.50 | ↑ +17% |
| Prime Net | FH-Medical Rental | $41.58 | ↑ +26% |
| UPMC Health Plan | CHIP | $42.50 | ↑ +29% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $46.75 | ↑ +42% |
Visitor-reported prices
Comments
Fibrinolytic plasminogen xcpt antgnc asa at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $66.60 | $5.00 – $88.80 |
| UPMC Bedford | Everett | $198.00 | $2.36 – $297.00 |
| UPMC Community Osteopathic | Harrisburg | $33.00 | $5.00 – $46.75 |
| UPMC East | Monroeville | $138.00 | $5.00 – $184.00 |
| UPMC Hamot | Erie | $103.80 | $5.00 – $17.79 |
| UPMC Northwest | Seneca | $97.20 | $5.50 – $7.05 |
| UPMC Hanover | Hanover | $33.00 | $5.00 – $10.45 |
| UPMC Horizon-Greenville | Greenville | $108.60 | $5.00 – $12.25 |