Fna bx w/ct gdn ea addl at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$314.40
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.
$524.00
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.
$71.79 with Prime Net 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $71.79 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $86.35 | ↓ -73% |
| Aetna | Medicare | $86.46 | ↓ -73% |
| UPMC Health Plan | Managed Medicaid | $88.39 | ↓ -72% |
| United Healthcare Community Plan for Families | PA Medicaid | $89.07 | ↓ -72% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $91.79 | ↓ -71% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $92.60 | ↓ -71% |
| Geisinger | Medicaid/CHIP | $99.03 | ↓ -69% |
| Keystone Health Plan | Medicare Advantage | $104.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $104.80 | ↓ -67% |
| PA Health & Wellness | PA Medicaid HMO | $115.87 | ↓ -63% |
| Prime Net | Legacy Commercial | $204.36 | ↓ -35% |
| Aetna | ACO | $205.93 | ↓ -35% |
| Prime Net | ACO | $205.93 | ↓ -35% |
| Prime Net | NonGateKeeper | $243.66 | ↓ -23% |
| Aetna | Commercial | $245.23 | ↓ -22% |
| Prime Net | GateKeeper | $245.23 | ↓ -22% |
| Capital Blue Cross | Commercial | $286.63 | ↓ -9% |
| Keystone Health Plan | Commercial | $286.63 | ↓ -9% |
| Capital Blue Cross | CHIP | $286.63 | ↓ -9% |
| Wellspan Population Health | PPO | $340.60 | ↑ +8% |
| Geisinger | Commercial | $343.12 | ↑ +9% |
| UPMC Work Partners | Workers Comp | $346.80 | ↑ +10% |
| UPMC Health Plan | Commercial | $366.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $396.14 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $445.40 | ↑ +42% |
| UPMC Health Plan | CHIP | $1,168.66 | ↑ +272% |
| Cigna | Commercial | $9,539.00 | ↑ +2934% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Fna bx w/ct gdn ea addl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $314.40 | $89.07 – $1,168.66 |
| UPMC Hanover | Hanover | $314.40 | $86.35 – $346.80 |
| UPMC Lititz | Lititz | $314.40 | $69.48 – $346.80 |
| UPMC Magee | Pittsburgh | $760.80 | $74.79 – $331.38 |
| UPMC Memorial | York | $314.40 | $69.48 – $346.80 |
| UPMC Mercy | Pittsburgh | $738.00 | $74.79 – $372.56 |
| UPMC Muncy | Muncy | $726.00 | $74.79 – $354.50 |
| UPMC Passavant-McCandless | Pittsburgh | $575.40 | $74.79 – $385.33 |