healthcosts.net
Ghs layer closure 2.5cm or less - 12051 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$520.80
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.
$868.00
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.
$40.01 with AmeriHealth Caritas vs $1,194.41 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $40.01 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $40.01 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $40.95 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $42.90 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $45.88 | ↓ -91% |
| PA Health & Wellness | PA Medicaid HMO | $53.68 | ↓ -90% |
| Prime Net | Managed Medicare | $118.92 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $173.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $173.60 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $263.59 | ↓ -49% |
| Prime Net | Legacy Commercial | $338.52 | ↓ -35% |
| Aetna | ACO | $341.12 | ↓ -35% |
| Prime Net | ACO | $341.12 | ↓ -35% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $378.38 | ↓ -27% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $378.38 | ↓ -27% |
| Humana | Medicare | $382.20 | ↓ -27% |
| Aetna | Medicare | $398.63 | ↓ -23% |
| UPMC Health Plan | CHIP | $399.95 | ↓ -23% |
| Geisinger | Medicare | $401.31 | ↓ -23% |
| Cigna | Medicare | $401.31 | ↓ -23% |
| Prime Net | NonGateKeeper | $403.62 | ↓ -23% |
| Prime Net | GateKeeper | $406.22 | ↓ -22% |
| Aetna | Commercial | $406.22 | ↓ -22% |
| United Healthcare | Medicare | $408.95 | ↓ -21% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $412.78 | ↓ -21% |
| Capital Blue Cross | CHIP | $474.80 | ↓ -9% |
| Capital Blue Cross | Commercial | $474.80 | ↓ -9% |
| Keystone Health Plan | Commercial | $474.80 | ↓ -9% |
| Wellspan Population Health | PPO | $564.20 | ↑ +8% |
| Geisinger | Commercial | $568.37 | ↑ +9% |
| UPMC Health Plan | Commercial | $607.60 | ↑ +17% |
| Keystone Autism Services | ACAP | $611.52 | ↑ +17% |
| United Healthcare Community Plan for Families | PA Medicaid | $645.83 | ↑ +24% |
| Prime Net | FH-Medical Rental | $656.21 | ↑ +26% |
| Cigna | Commercial | $677.04 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $737.80 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $1,074.98 | ↑ +106% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,120.46 | ↑ +115% |
| Highmark BCBS of PA | Commercial | $1,194.41 | ↑ +129% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs layer closure 2.5cm or less - 12051 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $574.80 | $31.50 – $766.40 |
| UPMC Bedford | Everett | $873.00 | $33.08 – $1,309.50 |
| UPMC Northwest | Seneca | $388.80 | $34.65 – $550.80 |
| UPMC Mercy | Pittsburgh | $308.40 | $34.65 – $462.60 |
| UPMC Muncy | Muncy | $825.60 | $34.65 – $1,100.80 |
| UPMC Passavant-McCandless | Pittsburgh | $763.20 | $34.65 – $1,081.20 |
| UPMC Presbyterian | Pittsburgh | $852.60 | $34.65 – $1,207.85 |
| UPMC Somerset | Somerset | $520.80 | $34.65 – $651.00 |