Fusion of foot bones at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
not published by hospital
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.
not published by hospital
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.
$491.49 with Highmark Wholecare (prev Gateway) vs $38,465.79 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 | $491.49 | — |
| UPMC Health Plan | Managed Medicaid | $503.10 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $522.45 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $527.09 | — |
| Geisinger | Medicaid/CHIP | $563.70 | — |
| PA Health & Wellness | PA Medicaid HMO | $659.53 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | — |
| UPMC Work Partners | Workers Comp | $1,998.26 | — |
| UPMC Health Plan | CHIP | $3,250.80 | — |
| Cigna | Commercial | $6,971.00 | — |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $12,185.57 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $12,185.57 | — |
| Humana | Medicare | $12,308.66 | — |
| Aetna | Medicare | $12,837.93 | — |
| Geisinger | Medicare | $12,924.09 | — |
| Cigna | Medicare | $12,924.09 | — |
| United Healthcare | Medicare | $13,170.27 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $13,293.35 | — |
| Keystone Autism Services | ACAP | $19,693.86 | — |
| Highmark BCBS of PA | Community Blue PPO | $34,619.34 | — |
| Highmark BCBS of PA | CHIP - Managed Care | $36,084.07 | — |
| Highmark BCBS of PA | Commercial | $38,465.79 | — |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Fusion of foot bones at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,262.40 | $406.35 – $1,909.45 |
| UPMC Altoona | Altoona | not published | $387.00 – $13,248.33 |
| UPMC Community Osteopathic | Harrisburg | not published | $522.45 – $13,542.81 |
| UPMC East | Monroeville | not published | $425.70 – $13,493.67 |
| UPMC Hamot | Erie | not published | $425.70 – $17,841.43 |
| UPMC Memorial | York | not published | $491.49 – $19,740.78 |
| UPMC Somerset | Somerset | not published | $425.70 – $12,266.97 |
| WellSpan Surgery & Rehabilitation Hospital | York PA 17403 | not published | $970.00 – $1,101.92 |