Ghs clsd red med malleolus fx without manip at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$831.60
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.
$1,386.00
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.
$126.21 with AmeriHealth Caritas vs $1,730.34 with UPMC Health Plan — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $126.21 | ↓ -85% |
| Prime Net | Managed Medicare | $189.88 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $227.18 | ↓ -73% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $227.18 | ↓ -73% |
| Humana | Medicare | $229.47 | ↓ -72% |
| Aetna | Medicare | $239.34 | ↓ -71% |
| Cigna | Medicare | $240.94 | ↓ -71% |
| Geisinger | Medicare | $240.94 | ↓ -71% |
| United Healthcare | Medicare | $245.53 | ↓ -70% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.83 | ↓ -70% |
| Keystone Health Plan | Medicare Advantage | $277.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $277.20 | ↓ -67% |
| Keystone Autism Services | ACAP | $367.15 | ↓ -56% |
| Prime Net | Legacy Commercial | $540.54 | ↓ -35% |
| Aetna | ACO | $544.70 | ↓ -34% |
| Prime Net | ACO | $544.70 | ↓ -34% |
| UPMC Work Partners | Workers Comp | $588.29 | ↓ -29% |
| Prime Net | NonGateKeeper | $644.49 | ↓ -23% |
| Highmark BCBS of PA | Community Blue PPO | $645.41 | ↓ -22% |
| Prime Net | GateKeeper | $648.65 | ↓ -22% |
| Aetna | Commercial | $648.65 | ↓ -22% |
| Highmark BCBS of PA | CHIP - Managed Care | $672.71 | ↓ -19% |
| Highmark BCBS of PA | Commercial | $717.12 | ↓ -14% |
| Keystone Health Plan | Commercial | $758.14 | ↓ -9% |
| Capital Blue Cross | CHIP | $758.14 | ↓ -9% |
| Capital Blue Cross | Commercial | $758.14 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $762.30 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $762.30 | ↓ -8% |
| Wellspan Population Health | PPO | $900.90 | ↑ +8% |
| Geisinger | Commercial | $907.55 | ↑ +9% |
| UPMC Health Plan | Commercial | $970.20 | ↑ +17% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +22% |
| Prime Net | FH-Medical Rental | $1,047.82 | ↑ +26% |
| Cigna | Commercial | $1,081.08 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,178.10 | ↑ +42% |
| UPMC Health Plan | CHIP | $1,730.34 | ↑ +108% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Ghs clsd red med malleolus fx without manip at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $2,628.00 | $82.51 – $3,942.00 |
| UPMC Cole | Coudersport | $1,266.00 | $74.01 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $831.60 | $233.61 – $1,730.34 |
| UPMC Hamot | Erie | $3,021.60 | $263.94 – $616.23 |
| UPMC Hanover | Hanover | $831.60 | $226.87 – $1,730.34 |
| UPMC Lititz | Lititz | $831.60 | $228.10 – $1,730.34 |
| UPMC Magee | Pittsburgh | $2,665.20 | $214.04 – $616.23 |
| UPMC Memorial | York | $831.60 | $239.91 – $1,730.34 |