Fine needle aspiration biopsy w/us gdn; ea addtl 10006 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,152.60
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.
$1,921.00
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.
$51.70 with Highmark Wholecare (prev Gateway) vs $9,539.00 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $51.70 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $52.92 | ↓ -95% |
| United Healthcare Community Plan for Families | PA Medicaid | $53.33 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $54.96 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $55.45 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $59.30 | ↓ -95% |
| PA Health & Wellness | PA Medicaid HMO | $69.38 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $76.49 | ↓ -93% |
| Prime Net | Managed Medicare | $263.18 | ↓ -77% |
| UPMC Health Plan | CHIP | $307.05 | ↓ -73% |
| Aetna | Medicare | $316.96 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $384.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $384.20 | ↓ -67% |
| Prime Net | Legacy Commercial | $749.19 | ↓ -35% |
| Prime Net | ACO | $754.95 | ↓ -35% |
| Aetna | ACO | $754.95 | ↓ -35% |
| Prime Net | NonGateKeeper | $893.26 | ↓ -23% |
| Prime Net | GateKeeper | $899.03 | ↓ -22% |
| Aetna | Commercial | $899.03 | ↓ -22% |
| Capital Blue Cross | CHIP | $1,050.79 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,050.79 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,050.79 | ↓ -9% |
| Wellspan Population Health | PPO | $1,248.65 | ↑ +8% |
| Geisinger | Commercial | $1,257.87 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,344.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,452.28 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,632.85 | ↑ +42% |
| Cigna | Commercial | $9,539.00 | ↑ +728% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Fine needle aspiration biopsy w/us gdn; ea addtl 10006 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $559.20 | $36.86 – $745.60 |
| UPMC Bedford | Everett | $1,597.80 | $42.75 – $2,396.70 |
| UPMC Cole | Coudersport | $87.60 | $40.47 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $1,152.60 | $53.33 – $1,632.85 |
| UPMC Hamot | Erie | $543.60 | $36.86 – $73.09 |
| UPMC Northwest | Seneca | $777.00 | $44.78 – $95.67 |
| UPMC Hanover | Hanover | $1,152.60 | $51.70 – $76.49 |
| UPMC Horizon-Greenville | Greenville | $741.00 | $42.75 – $73.09 |