Inj, factor x, (human), 1iu at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$6.60
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.
$11.00
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.
$1.51 with Prime Net vs $30.56 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 | $1.51 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $2.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2.20 | ↓ -67% |
| Keystone Health Plan | Commercial | $3.53 | ↓ -47% |
| Capital Blue Cross | CHIP | $3.53 | ↓ -47% |
| Capital Blue Cross | Commercial | $3.53 | ↓ -47% |
| Prime Net | Legacy Commercial | $4.29 | ↓ -35% |
| Aetna | ACO | $4.32 | ↓ -35% |
| Prime Net | ACO | $4.32 | ↓ -35% |
| UPMC Work Partners | Workers Comp | $4.48 | ↓ -32% |
| Prime Net | NonGateKeeper | $5.12 | ↓ -22% |
| Prime Net | GateKeeper | $5.15 | ↓ -22% |
| Aetna | Commercial | $5.15 | ↓ -22% |
| United Healthcare | Commercial | $6.78 | ↑ +3% |
| Wellspan Population Health | PPO | $7.15 | ↑ +8% |
| Geisinger | Commercial | $7.20 | ↑ +9% |
| UPMC Health Plan | Commercial | $7.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $8.32 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $9.35 | ↑ +42% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $9.68 | ↑ +47% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $9.68 | ↑ +47% |
| PA Health & Wellness | PA Medicaid HMO | $9.78 | ↑ +48% |
| Geisinger | Medicaid/CHIP | $9.78 | ↑ +48% |
| Humana | Medicare | $9.78 | ↑ +48% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $9.78 | ↑ +48% |
| Highmark Wholecare (prev Gateway) | Medicaid | $9.97 | ↑ +51% |
| Aetna | Medicare | $10.20 | ↑ +55% |
| Cigna | Medicare | $10.27 | ↑ +56% |
| Geisinger | Medicare | $10.27 | ↑ +56% |
| United Healthcare | Medicare | $10.46 | ↑ +58% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10.56 | ↑ +60% |
| UPMC Health Plan | Managed Medicaid | $10.75 | ↑ +63% |
| UPMC Health Plan | CHIP | $12.02 | ↑ +82% |
| Cigna | Commercial | $12.85 | ↑ +95% |
| Keystone Autism Services | ACAP | $15.65 | ↑ +137% |
| Highmark BCBS of PA | Community Blue PPO | $27.51 | ↑ +317% |
| Highmark BCBS of PA | CHIP - Managed Care | $28.67 | ↑ +334% |
| Highmark BCBS of PA | Commercial | $30.56 | ↑ +363% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Inj, factor x, (human), 1iu at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $37.80 | $5.73 – $50.40 |
| UPMC Bedford | Everett | $36.00 | $3.53 – $54.00 |
| UPMC Community Osteopathic | Harrisburg | $6.60 | $2.20 – $12.02 |
| UPMC Hamot | Erie | $33.60 | $5.73 – $10.56 |
| UPMC Northwest | Seneca | $34.20 | $6.17 – $10.56 |
| UPMC Hanover | Hanover | $6.60 | $9.68 – $15.65 |
| UPMC Horizon-Greenville | Greenville | $32.40 | $6.17 – $14.59 |
| UPMC Lititz | Lititz | $6.60 | $9.68 – $15.65 |