Ghs simple repair 5.1 - 7.5 cm - 12014 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$808.20
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.
?
What you pay up front if you don't use insurance.
$1,347.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$60.33 with AmeriHealth Caritas vs $1,144.95 with Multiplan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $60.33 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $60.33 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $61.75 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $64.69 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $69.19 | ↓ -91% |
| PA Health & Wellness | PA Medicaid HMO | $80.95 | ↓ -90% |
| Prime Net | Managed Medicare | $184.54 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $188.18 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $188.18 | ↓ -77% |
| Humana | Medicare | $190.08 | ↓ -76% |
| Aetna | Medicare | $198.25 | ↓ -75% |
| Geisinger | Medicare | $199.58 | ↓ -75% |
| Cigna | Medicare | $199.58 | ↓ -75% |
| United Healthcare | Medicare | $203.39 | ↓ -75% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $205.29 | ↓ -75% |
| Keystone Health Plan | Medicare Advantage | $269.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $269.40 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $288.20 | ↓ -64% |
| Keystone Autism Services | ACAP | $304.13 | ↓ -62% |
| Prime Net | Legacy Commercial | $525.33 | ↓ -35% |
| Aetna | ACO | $529.37 | ↓ -35% |
| Prime Net | ACO | $529.37 | ↓ -35% |
| Highmark BCBS of PA | Community Blue PPO | $534.62 | ↓ -34% |
| Highmark BCBS of PA | CHIP - Managed Care | $557.24 | ↓ -31% |
| Highmark BCBS of PA | Commercial | $594.02 | ↓ -27% |
| Prime Net | NonGateKeeper | $626.36 | ↓ -22% |
| Prime Net | GateKeeper | $630.40 | ↓ -22% |
| Aetna | Commercial | $630.40 | ↓ -22% |
| UPMC Health Plan | CHIP | $653.97 | ↓ -19% |
| Keystone Health Plan | Commercial | $736.81 | ↓ -9% |
| Capital Blue Cross | Commercial | $736.81 | ↓ -9% |
| Capital Blue Cross | CHIP | $736.81 | ↓ -9% |
| Wellspan Population Health | PPO | $875.55 | ↑ +8% |
| Geisinger | Commercial | $882.02 | ↑ +9% |
| UPMC Health Plan | Commercial | $942.90 | ↑ +17% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +26% |
| Prime Net | FH-Medical Rental | $1,018.33 | ↑ +26% |
| Cigna | Commercial | $1,050.66 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,144.95 | ↑ +42% |
| 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 simple repair 5.1 - 7.5 cm - 12014 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $518.40 | $47.50 – $691.20 |
| UPMC Bedford | Everett | $454.20 | $49.88 – $681.30 |
| UPMC Cole | Coudersport | $609.60 | $49.88 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $808.20 | $60.33 – $1,144.95 |
| UPMC East | Monroeville | $856.80 | $52.25 – $1,142.40 |
| UPMC Hamot | Erie | $880.20 | $52.25 – $293.20 |
| UPMC Northwest | Seneca | $610.80 | $52.25 – $300.42 |
| UPMC Hanover | Hanover | $808.20 | $60.33 – $1,016.56 |