Hdr rdncl ntrstl/icav brchtx at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2,553.60
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.
$4,256.00
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.
$216.56 with United Healthcare Community Plan for Families vs $26,132.00 with United Healthcare — 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 | $216.56 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $311.47 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $311.47 | ↓ -88% |
| UPMC Health Plan | Managed Medicaid | $318.82 | ↓ -88% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $334.03 | ↓ -87% |
| Geisinger | Medicaid/CHIP | $357.23 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $417.96 | ↓ -84% |
| UPMC Work Partners | Workers Comp | $429.40 | ↓ -83% |
| Prime Net | Managed Medicare | $583.07 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $657.07 | ↓ -74% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $657.07 | ↓ -74% |
| Humana | Medicare | $663.71 | ↓ -74% |
| Aetna | Medicare | $692.25 | ↓ -73% |
| Geisinger | Medicare | $696.90 | ↓ -73% |
| Cigna | Medicare | $696.90 | ↓ -73% |
| United Healthcare | Medicare | $710.17 | ↓ -72% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $716.81 | ↓ -72% |
| Capital Blue Cross | Medicare Advantage | $851.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $851.20 | ↓ -67% |
| Keystone Autism Services | ACAP | $1,061.94 | ↓ -58% |
| Prime Net | Legacy Commercial | $1,659.84 | ↓ -35% |
| Aetna | ACO | $1,672.61 | ↓ -34% |
| Prime Net | ACO | $1,672.61 | ↓ -34% |
| Highmark BCBS of PA | Community Blue PPO | $1,866.75 | ↓ -27% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,945.73 | ↓ -24% |
| Prime Net | NonGateKeeper | $1,979.04 | ↓ -23% |
| Aetna | Commercial | $1,991.81 | ↓ -22% |
| Prime Net | GateKeeper | $1,991.81 | ↓ -22% |
| Highmark BCBS of PA | Commercial | $2,074.16 | ↓ -19% |
| Capital Blue Cross | CHIP | $2,328.03 | ↓ -9% |
| Keystone Health Plan | Commercial | $2,328.03 | ↓ -9% |
| Capital Blue Cross | Commercial | $2,328.03 | ↓ -9% |
| Wellspan Population Health | PPO | $2,766.40 | ↑ +8% |
| Geisinger | Commercial | $2,786.83 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,979.20 | ↑ +17% |
| UPMC Health Plan | CHIP | $3,045.17 | ↑ +19% |
| Prime Net | FH-Medical Rental | $3,217.54 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,617.60 | ↑ +42% |
| Cigna | Commercial | $3,891.79 | ↑ +52% |
| United Healthcare | Commercial | $26,132.00 | ↑ +923% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Hdr rdncl ntrstl/icav brchtx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,364.80 | $144.39 – $4,486.40 |
| UPMC Community Osteopathic | Harrisburg | $2,553.60 | $216.56 – $3,617.60 |
| UPMC East | Monroeville | $861.00 | $145.77 – $1,148.00 |
| UPMC Lititz | Lititz | $2,553.60 | $216.56 – $1,066.21 |
| UPMC Magee | Pittsburgh | $7,324.80 | $145.77 – $714.38 |
| UPMC Memorial | York | $2,553.60 | $117.69 – $1,350.95 |
| UPMC Passavant-McCandless | Pittsburgh | $7,995.60 | $145.77 – $727.61 |
| UPMC Somerset | Somerset | $2,553.60 | $142.93 – $661.46 |