HIV prep, ftc/tdf 200/300mg at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$36.60
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.
$61.00
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.
$0.14 with Prime Net vs $5.41 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $0.14 | ↓ -100% |
| Keystone Health Plan | Medicare Advantage | $0.20 | ↓ -99% |
| Capital Blue Cross | Medicare Advantage | $0.20 | ↓ -99% |
| Capital Blue Cross | Commercial | $0.32 | ↓ -99% |
| Keystone Health Plan | Commercial | $0.32 | ↓ -99% |
| Capital Blue Cross | CHIP | $0.32 | ↓ -99% |
| Aetna | ACO | $0.39 | ↓ -99% |
| Prime Net | ACO | $0.39 | ↓ -99% |
| Prime Net | Legacy Commercial | $0.39 | ↓ -99% |
| UPMC Work Partners | Workers Comp | $0.41 | ↓ -99% |
| Aetna | Commercial | $0.47 | ↓ -99% |
| Prime Net | GateKeeper | $0.47 | ↓ -99% |
| Prime Net | NonGateKeeper | $0.47 | ↓ -99% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $0.59 | ↓ -98% |
| United Healthcare | Commercial | $0.62 | ↓ -98% |
| Wellspan Population Health | PPO | $0.65 | ↓ -98% |
| Geisinger | Commercial | $0.65 | ↓ -98% |
| UPMC Health Plan | Commercial | $0.70 | ↓ -98% |
| Prime Net | FH-Medical Rental | $0.76 | ↓ -98% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $0.85 | ↓ -98% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1.71 | ↓ -95% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1.71 | ↓ -95% |
| Cigna | Commercial | $1.72 | ↓ -95% |
| PA Health & Wellness | PA Medicaid HMO | $1.73 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1.73 | ↓ -95% |
| Humana | Medicare | $1.73 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $1.73 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1.77 | ↓ -95% |
| Aetna | Medicare | $1.80 | ↓ -95% |
| Cigna | Medicare | $1.82 | ↓ -95% |
| Geisinger | Medicare | $1.82 | ↓ -95% |
| United Healthcare | Medicare | $1.85 | ↓ -95% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1.87 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $1.91 | ↓ -95% |
| UPMC Health Plan | CHIP | $2.13 | ↓ -94% |
| Keystone Autism Services | ACAP | $2.77 | ↓ -92% |
| Highmark BCBS of PA | Community Blue PPO | $4.87 | ↓ -87% |
| Highmark BCBS of PA | CHIP - Managed Care | $5.07 | ↓ -86% |
| Highmark BCBS of PA | Commercial | $5.41 | ↓ -85% |
Visitor-reported prices
Comments
HIV prep, ftc/tdf 200/300mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $36.60 | $0.20 – $2.13 |
| UPMC Hanover | Hanover | $36.60 | $0.59 – $2.77 |
| UPMC Lititz | Lititz | $36.60 | $0.59 – $2.77 |
| UPMC Memorial | York | $36.60 | $0.41 – $66.51 |
| UPMC Somerset | Somerset | $36.60 | $0.50 – $1.73 |
| Uniontown Hospital | Uniontown | $3.81 | $0.45 – $2.21 |