Ghs polysom <6 yrs 4/> parameters at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$5,327.40
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.
$8,879.00
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.
$879.40 with United Healthcare Community Plan for Families vs $7,547.15 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $879.40 | ↓ -83% |
| UPMC Health Plan | CHIP | $922.88 | ↓ -83% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $963.53 | ↓ -82% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $963.53 | ↓ -82% |
| Humana | Medicare | $973.26 | ↓ -82% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $979.45 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicaid | $979.45 | ↓ -82% |
| UPMC Health Plan | Managed Medicaid | $1,002.59 | ↓ -81% |
| Aetna | Medicare | $1,015.11 | ↓ -81% |
| Cigna | Medicare | $1,021.92 | ↓ -81% |
| Geisinger | Medicare | $1,021.92 | ↓ -81% |
| United Healthcare | Medicare | $1,041.39 | ↓ -80% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $1,050.40 | ↓ -80% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,051.12 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $1,123.36 | ↓ -79% |
| Prime Net | Managed Medicare | $1,216.42 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $1,314.31 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $1,439.89 | ↓ -73% |
| Keystone Autism Services | ACAP | $1,557.22 | ↓ -71% |
| Keystone Health Plan | Medicare Advantage | $1,775.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,775.80 | ↓ -67% |
| Highmark BCBS of PA | Community Blue PPO | $2,737.39 | ↓ -49% |
| Highmark BCBS of PA | CHIP - Managed Care | $2,853.21 | ↓ -46% |
| Highmark BCBS of PA | Commercial | $3,041.53 | ↓ -43% |
| Prime Net | Legacy Commercial | $3,462.81 | ↓ -35% |
| Prime Net | ACO | $3,489.45 | ↓ -34% |
| Aetna | ACO | $3,489.45 | ↓ -34% |
| United Healthcare | Commercial | $3,865.00 | ↓ -27% |
| Prime Net | NonGateKeeper | $4,128.73 | ↓ -23% |
| Aetna | Commercial | $4,155.37 | ↓ -22% |
| Prime Net | GateKeeper | $4,155.37 | ↓ -22% |
| Capital Blue Cross | CHIP | $4,856.81 | ↓ -9% |
| Keystone Health Plan | Commercial | $4,856.81 | ↓ -9% |
| Capital Blue Cross | Commercial | $4,856.81 | ↓ -9% |
| Wellspan Population Health | PPO | $5,771.35 | ↑ +8% |
| Geisinger | Commercial | $5,813.97 | ↑ +9% |
| UPMC Health Plan | Commercial | $6,215.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $6,712.52 | ↑ +26% |
| Cigna | Commercial | $6,925.62 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $7,547.15 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Ghs polysom <6 yrs 4/> parameters at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hanover | Hanover | $5,327.40 | $879.40 – $1,555.06 |
| UPMC Lititz | Lititz | $5,327.40 | $879.40 – $1,563.46 |
| UPMC Memorial | York | $5,327.40 | $583.15 – $1,560.93 |
| UPMC Wellsboro | Wellsboro | $4,187.20 | $848.34 – $1,375.90 |
| WellSpan Chambersburg Hospital | Chambersburg | $4,918.40 | $964.02 – $4,679.08 |
| Uniontown Hospital | Uniontown | $3,217.00 | $90.08 – $1,728.77 |