Inj nephrosto/ureterogram w/img exstng access at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,266.00
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.
$2,110.00
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.
$218.97 with UPMC Work Partners vs $6,413.00 with Cigna — 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $218.97 | ↓ -83% |
| Prime Net | Managed Medicare | $289.07 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $351.19 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $422.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $422.00 | ↓ -67% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $632.13 | ↓ -50% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $632.13 | ↓ -50% |
| Humana | Medicare | $638.52 | ↓ -50% |
| Aetna | Medicare | $665.98 | ↓ -47% |
| Geisinger | Medicare | $670.45 | ↓ -47% |
| Cigna | Medicare | $670.45 | ↓ -47% |
| United Healthcare | Medicare | $683.22 | ↓ -46% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $689.60 | ↓ -46% |
| Prime Net | Legacy Commercial | $822.90 | ↓ -35% |
| Aetna | ACO | $829.23 | ↓ -35% |
| Prime Net | ACO | $829.23 | ↓ -35% |
| Prime Net | NonGateKeeper | $981.15 | ↓ -23% |
| Aetna | Commercial | $987.48 | ↓ -22% |
| Prime Net | GateKeeper | $987.48 | ↓ -22% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -20% |
| Keystone Autism Services | ACAP | $1,021.63 | ↓ -19% |
| Capital Blue Cross | CHIP | $1,154.17 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,154.17 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,154.17 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $1,160.50 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $1,160.50 | ↓ -8% |
| UPMC Health Plan | CHIP | $1,355.70 | ↑ +7% |
| Wellspan Population Health | PPO | $1,371.50 | ↑ +8% |
| Geisinger | Commercial | $1,381.63 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,477.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,595.16 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,793.50 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $1,795.90 | ↑ +42% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,871.89 | ↑ +48% |
| Highmark BCBS of PA | Commercial | $1,995.44 | ↑ +58% |
| Cigna | Commercial | $6,413.00 | ↑ +407% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Inj nephrosto/ureterogram w/img exstng access at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,977.00 | $109.24 – $2,636.00 |
| UPMC Bedford | Everett | $2,092.80 | $209.24 – $3,139.20 |
| UPMC Community Osteopathic | Harrisburg | $1,266.00 | $218.97 – $1,793.50 |
| UPMC East | Monroeville | $2,092.80 | $110.28 – $2,790.40 |
| UPMC Hamot | Erie | $2,189.40 | $109.24 – $925.53 |
| UPMC Northwest | Seneca | $2,092.80 | $209.24 – $687.26 |
| UPMC Hanover | Hanover | $1,266.00 | $218.97 – $1,355.70 |
| UPMC Horizon-Greenville | Greenville | $1,019.40 | $209.24 – $687.26 |