Ghs layer closure 7.6 - 12.5 cm - 12054 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,200.60
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.
$2,001.00
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.
$78.11 with Highmark Wholecare (prev Gateway) vs $2,297.40 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $78.11 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $78.11 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $79.95 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $83.76 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $89.58 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $104.81 | ↓ -91% |
| Prime Net | Managed Medicare | $274.14 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $378.38 | ↓ -68% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $378.38 | ↓ -68% |
| Humana | Medicare | $382.20 | ↓ -68% |
| Aetna | Medicare | $398.63 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $400.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $400.20 | ↓ -67% |
| Cigna | Medicare | $401.31 | ↓ -67% |
| Geisinger | Medicare | $401.31 | ↓ -67% |
| United Healthcare | Medicare | $408.95 | ↓ -66% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $412.78 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $591.09 | ↓ -51% |
| Keystone Autism Services | ACAP | $611.52 | ↓ -49% |
| United Healthcare Community Plan for Families | PA Medicaid | $719.19 | ↓ -40% |
| Prime Net | Legacy Commercial | $780.39 | ↓ -35% |
| Prime Net | ACO | $786.39 | ↓ -35% |
| Aetna | ACO | $786.39 | ↓ -35% |
| Prime Net | NonGateKeeper | $930.47 | ↓ -22% |
| Prime Net | GateKeeper | $936.47 | ↓ -22% |
| Aetna | Commercial | $936.47 | ↓ -22% |
| Highmark BCBS of PA | Community Blue PPO | $1,074.98 | ↓ -10% |
| Keystone Health Plan | Commercial | $1,094.55 | ↓ -9% |
| Capital Blue Cross | CHIP | $1,094.55 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,094.55 | ↓ -9% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,120.46 | ↓ -7% |
| Highmark BCBS of PA | Commercial | $1,194.41 | ↓ -1% |
| Wellspan Population Health | PPO | $1,300.65 | ↑ +8% |
| Geisinger | Commercial | $1,310.25 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,400.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,512.76 | ↑ +26% |
| Cigna | Commercial | $1,560.78 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,700.85 | ↑ +42% |
| UPMC Health Plan | CHIP | $2,297.40 | ↑ +91% |
| 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 layer closure 7.6 - 12.5 cm - 12054 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,287.00 | $61.50 – $1,716.00 |
| UPMC Bedford | Everett | $4,057.20 | $64.58 – $6,085.80 |
| UPMC Cole | Coudersport | $1,693.20 | $64.58 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $1,200.60 | $78.11 – $2,297.40 |
| UPMC East | Monroeville | $3,242.40 | $67.65 – $4,323.20 |
| UPMC Hamot | Erie | $3,098.40 | $67.65 – $729.80 |
| UPMC Hanover | Hanover | $1,200.60 | $78.11 – $719.19 |
| UPMC Horizon-Greenville | Greenville | $2,905.80 | $67.65 – $714.76 |