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Flexible Sigmoidoscopy at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,158.00
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.
$1,930.00
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.
$67.50 with Highmark Wholecare (prev Gateway) vs $2,725.59 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $67.50 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $67.50 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $69.09 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $72.39 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $77.42 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $90.58 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $202.56 | ↓ -83% |
| Prime Net | Managed Medicare | $264.41 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $386.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $386.00 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $441.47 | ↓ -62% |
| Prime Net | Legacy Commercial | $752.70 | ↓ -35% |
| Aetna | ACO | $758.49 | ↓ -35% |
| Prime Net | ACO | $758.49 | ↓ -35% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $863.44 | ↓ -25% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $863.44 | ↓ -25% |
| Humana | Medicare | $872.16 | ↓ -25% |
| Prime Net | NonGateKeeper | $897.45 | ↓ -23% |
| Prime Net | GateKeeper | $903.24 | ↓ -22% |
| Aetna | Commercial | $903.24 | ↓ -22% |
| Aetna | Medicare | $909.66 | ↓ -21% |
| Cigna | Medicare | $915.77 | ↓ -21% |
| Geisinger | Medicare | $915.77 | ↓ -21% |
| United Healthcare | Medicare | $933.21 | ↓ -19% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $941.93 | ↓ -19% |
| UPMC Health Plan | CHIP | $1,047.20 | ↓ -10% |
| Capital Blue Cross | CHIP | $1,055.71 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,055.71 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,055.71 | ↓ -9% |
| Wellspan Population Health | PPO | $1,254.50 | ↑ +8% |
| Geisinger | Commercial | $1,263.76 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,351.00 | ↑ +17% |
| Keystone Autism Services | ACAP | $1,395.46 | ↑ +21% |
| Prime Net | FH-Medical Rental | $1,459.08 | ↑ +26% |
| Cigna | Commercial | $1,505.40 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,640.50 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $2,453.04 | ↑ +112% |
| Highmark BCBS of PA | CHIP - Managed Care | $2,556.82 | ↑ +121% |
| Highmark BCBS of PA | Commercial | $2,725.59 | ↑ +135% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Flexible Sigmoidoscopy at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $598.20 | $58.47 – $956.13 |
| UPMC East | Monroeville | $598.20 | $58.47 – $912.67 |
| UPMC Hamot | Erie | $598.20 | $58.47 – $1,264.19 |
| UPMC Altoona | Altoona | $598.20 | $53.15 – $797.60 |
| UPMC Bedford | Everett | $598.20 | $55.81 – $897.30 |
| UPMC Cole | Coudersport | $176.40 | $55.81 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $1,158.00 | $67.50 – $1,640.50 |
| UPMC Hanover | Hanover | $1,158.00 | $67.50 – $1,679.10 |