Gamunex-c/gammaked at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$7.80
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.
$13.00
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.
$1.78 with Prime Net vs $153.00 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $1.78 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $2.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2.60 | ↓ -67% |
| Keystone Health Plan | Commercial | $4.17 | ↓ -47% |
| Capital Blue Cross | CHIP | $4.17 | ↓ -47% |
| Capital Blue Cross | Commercial | $4.17 | ↓ -47% |
| Prime Net | Legacy Commercial | $5.07 | ↓ -35% |
| Aetna | ACO | $5.11 | ↓ -34% |
| Prime Net | ACO | $5.11 | ↓ -34% |
| UPMC Work Partners | Workers Comp | $5.29 | ↓ -32% |
| Prime Net | NonGateKeeper | $6.04 | ↓ -23% |
| Prime Net | GateKeeper | $6.08 | ↓ -22% |
| Aetna | Commercial | $6.08 | ↓ -22% |
| United Healthcare | Commercial | $8.01 | ↑ +3% |
| Wellspan Population Health | PPO | $8.45 | ↑ +8% |
| Geisinger | Commercial | $8.51 | ↑ +9% |
| UPMC Health Plan | Commercial | $9.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $9.83 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $11.05 | ↑ +42% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $48.47 | ↑ +521% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $48.47 | ↑ +521% |
| PA Health & Wellness | PA Medicaid HMO | $48.96 | ↑ +528% |
| Geisinger | Medicaid/CHIP | $48.96 | ↑ +528% |
| Humana | Medicare | $48.96 | ↑ +528% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $48.96 | ↑ +528% |
| Highmark Wholecare (prev Gateway) | Medicaid | $49.94 | ↑ +540% |
| Aetna | Medicare | $51.07 | ↑ +555% |
| Cigna | Medicare | $51.41 | ↑ +559% |
| Geisinger | Medicare | $51.41 | ↑ +559% |
| United Healthcare | Medicare | $52.39 | ↑ +572% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $52.88 | ↑ +578% |
| UPMC Health Plan | Managed Medicaid | $53.86 | ↑ +591% |
| UPMC Health Plan | CHIP | $60.23 | ↑ +672% |
| Cigna | Commercial | $70.20 | ↑ +800% |
| Keystone Autism Services | ACAP | $78.34 | ↑ +904% |
| Highmark BCBS of PA | Community Blue PPO | $137.70 | ↑ +1665% |
| Highmark BCBS of PA | CHIP - Managed Care | $143.53 | ↑ +1740% |
| Highmark BCBS of PA | Commercial | $153.00 | ↑ +1862% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Gamunex-c/gammaked at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $359.20 | $30.92 – $324.80 |
| UPMC Bedford | Everett | $345.60 | $17.66 – $386.10 |
| UPMC Cole | Coudersport | $3,381.60 | $48.96 – $2,486.40 |
| UPMC East | Monroeville | $433.60 | $30.92 – $433.60 |
| UPMC Hamot | Erie | $362.40 | $30.92 – $90.45 |
| UPMC Northwest | Seneca | $345.60 | $30.92 – $52.88 |
| UPMC Horizon-Greenville | Greenville | $343.20 | $30.92 – $91.87 |
| UPMC Jameson | New Castle | $616.80 | $30.92 – $93.22 |