Ghs i and d perirectal abscess 46040 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$3,564.60
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.
$5,941.00
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.
$137.79 with AmeriHealth Caritas vs $5,049.85 with Multiplan — 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 | $137.79 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $137.79 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $141.05 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $147.78 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $158.04 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $184.91 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $663.03 | ↓ -81% |
| Prime Net | Managed Medicare | $813.92 | ↓ -77% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -71% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,116.65 | ↓ -69% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,116.65 | ↓ -69% |
| Humana | Medicare | $1,127.93 | ↓ -68% |
| Aetna | Medicare | $1,176.43 | ↓ -67% |
| Geisinger | Medicare | $1,184.33 | ↓ -67% |
| Cigna | Medicare | $1,184.33 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,188.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,188.20 | ↓ -67% |
| United Healthcare | Medicare | $1,206.89 | ↓ -66% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,218.16 | ↓ -66% |
| Keystone Autism Services | ACAP | $1,804.69 | ↓ -49% |
| Prime Net | Legacy Commercial | $2,316.99 | ↓ -35% |
| Prime Net | ACO | $2,334.81 | ↓ -35% |
| Aetna | ACO | $2,334.81 | ↓ -35% |
| UPMC Health Plan | CHIP | $2,637.15 | ↓ -26% |
| Prime Net | NonGateKeeper | $2,762.57 | ↓ -22% |
| Aetna | Commercial | $2,780.39 | ↓ -22% |
| Prime Net | GateKeeper | $2,780.39 | ↓ -22% |
| Highmark BCBS of PA | Community Blue PPO | $3,172.42 | ↓ -11% |
| Capital Blue Cross | Commercial | $3,249.73 | ↓ -9% |
| Capital Blue Cross | CHIP | $3,249.73 | ↓ -9% |
| Keystone Health Plan | Commercial | $3,249.73 | ↓ -9% |
| Highmark BCBS of PA | CHIP - Managed Care | $3,306.64 | ↓ -7% |
| Highmark BCBS of PA | Commercial | $3,524.89 | ↓ -1% |
| Wellspan Population Health | PPO | $3,861.65 | ↑ +8% |
| Geisinger | Commercial | $3,890.17 | ↑ +9% |
| UPMC Health Plan | Commercial | $4,158.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $4,491.40 | ↑ +26% |
| Cigna | Commercial | $4,633.98 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $5,049.85 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Ghs i and d perirectal abscess 46040 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,184.80 | $108.50 – $4,246.40 |
| UPMC Bedford | Everett | $5,790.00 | $113.92 – $8,685.00 |
| UPMC Cole | Coudersport | $1,941.60 | $113.92 – $1,192.92 |
| UPMC Community Osteopathic | Harrisburg | $3,564.60 | $137.79 – $5,049.85 |
| UPMC East | Monroeville | $2,616.00 | $119.35 – $3,488.00 |
| UPMC Hamot | Erie | $3,558.60 | $119.35 – $1,634.95 |
| UPMC Northwest | Seneca | $5,469.60 | $119.35 – $1,180.32 |
| UPMC Hanover | Hanover | $3,564.60 | $137.79 – $1,802.21 |