G-tube reposition at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$978.00
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.
$1,630.00
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.
$119.93 with Highmark Wholecare (prev Gateway) vs $3,397.00 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 | $119.93 | ↓ -88% |
| UPMC Health Plan | Managed Medicaid | $122.76 | ↓ -87% |
| United Healthcare Community Plan for Families | PA Medicaid | $123.70 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $127.48 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $128.61 | ↓ -87% |
| Geisinger | Medicaid/CHIP | $137.55 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $160.93 | ↓ -84% |
| Prime Net | Managed Medicare | $223.31 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $230.33 | ↓ -76% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $230.33 | ↓ -76% |
| Humana | Medicare | $232.66 | ↓ -76% |
| Aetna | Medicare | $242.66 | ↓ -75% |
| Cigna | Medicare | $244.29 | ↓ -75% |
| Geisinger | Medicare | $244.29 | ↓ -75% |
| United Healthcare | Medicare | $248.95 | ↓ -75% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $251.27 | ↓ -74% |
| UPMC Work Partners | Workers Comp | $294.18 | ↓ -70% |
| Keystone Health Plan | Medicare Advantage | $326.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $326.00 | ↓ -67% |
| Keystone Autism Services | ACAP | $372.26 | ↓ -62% |
| Prime Net | Legacy Commercial | $635.70 | ↓ -35% |
| Prime Net | ACO | $640.59 | ↓ -35% |
| Aetna | ACO | $640.59 | ↓ -35% |
| Highmark BCBS of PA | Community Blue PPO | $654.38 | ↓ -33% |
| Highmark BCBS of PA | CHIP - Managed Care | $682.07 | ↓ -30% |
| Highmark BCBS of PA | Commercial | $727.09 | ↓ -26% |
| Prime Net | NonGateKeeper | $757.95 | ↓ -23% |
| Aetna | Commercial | $762.84 | ↓ -22% |
| Prime Net | GateKeeper | $762.84 | ↓ -22% |
| Capital Blue Cross | CHIP | $891.61 | ↓ -9% |
| Capital Blue Cross | Commercial | $891.61 | ↓ -9% |
| Keystone Health Plan | Commercial | $891.61 | ↓ -9% |
| Wellspan Population Health | PPO | $1,059.50 | ↑ +8% |
| Geisinger | Commercial | $1,067.32 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,141.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,232.28 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,385.50 | ↑ +42% |
| UPMC Health Plan | CHIP | $2,299.02 | ↑ +135% |
| Cigna | Commercial | $3,397.00 | ↑ +247% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
G-tube reposition at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,710.60 | $94.43 – $2,280.80 |
| UPMC Community Osteopathic | Harrisburg | $978.00 | $123.70 – $2,299.02 |
| UPMC East | Monroeville | $3,055.20 | $103.87 – $4,073.60 |
| UPMC Hamot | Erie | $3,123.00 | $103.87 – $729.80 |
| UPMC Hanover | Hanover | $978.00 | $119.93 – $371.74 |
| UPMC Lititz | Lititz | $978.00 | $119.93 – $373.74 |
| UPMC Magee | Pittsburgh | $2,278.20 | $103.87 – $736.75 |
| UPMC Memorial | York | $978.00 | $119.93 – $594.82 |