Inj., tildrakizumab, 1 mg at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$10,342.20
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.
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What you pay up front if you don't use insurance.
$17,237.00
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.
$126.18 with Highmark BCBS of PA vs $14,651.45 with Multiplan — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $126.18 | ↓ -99% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $126.18 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $127.45 | ↓ -99% |
| Humana | Medicare | $127.45 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $127.45 | ↓ -99% |
| PA Health & Wellness | PA Medicaid HMO | $127.45 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $130.00 | ↓ -99% |
| Aetna | Medicare | $132.93 | ↓ -99% |
| Cigna | Medicare | $133.82 | ↓ -99% |
| Geisinger | Medicare | $133.82 | ↓ -99% |
| United Healthcare | Medicare | $136.37 | ↓ -99% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $137.65 | ↓ -99% |
| UPMC Health Plan | Managed Medicaid | $140.20 | ↓ -99% |
| UPMC Health Plan | CHIP | $156.77 | ↓ -98% |
| Cigna | Commercial | $198.33 | ↓ -98% |
| Keystone Autism Services | ACAP | $203.92 | ↓ -98% |
| Highmark BCBS of PA | Community Blue PPO | $358.47 | ↓ -97% |
| Highmark BCBS of PA | CHIP - Managed Care | $373.63 | ↓ -96% |
| Highmark BCBS of PA | Commercial | $398.29 | ↓ -96% |
| United Healthcare | Commercial | $987.79 | ↓ -90% |
| Prime Net | Managed Medicare | $2,361.47 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $3,447.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $3,447.40 | ↓ -67% |
| Capital Blue Cross | CHIP | $5,533.08 | ↓ -46% |
| Keystone Health Plan | Commercial | $5,533.08 | ↓ -46% |
| Capital Blue Cross | Commercial | $5,533.08 | ↓ -46% |
| Prime Net | Legacy Commercial | $6,722.43 | ↓ -35% |
| Aetna | ACO | $6,774.14 | ↓ -35% |
| Prime Net | ACO | $6,774.14 | ↓ -35% |
| UPMC Work Partners | Workers Comp | $7,018.91 | ↓ -32% |
| Prime Net | NonGateKeeper | $8,015.20 | ↓ -23% |
| Aetna | Commercial | $8,066.92 | ↓ -22% |
| Prime Net | GateKeeper | $8,066.92 | ↓ -22% |
| Wellspan Population Health | PPO | $11,204.05 | ↑ +8% |
| Geisinger | Commercial | $11,286.79 | ↑ +9% |
| UPMC Health Plan | Commercial | $12,065.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $13,031.17 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $14,651.45 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Inj., tildrakizumab, 1 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $10,342.20 | $126.18 – $14,651.45 |
| UPMC Hamot | Erie | $32,438.40 | $80.47 – $137.65 |
| UPMC Hanover | Hanover | $10,342.20 | $126.18 – $203.92 |
| UPMC Lititz | Lititz | $10,342.20 | $126.18 – $203.92 |
| UPMC Memorial | York | $10,342.20 | $96.52 – $203.92 |
| UPMC Somerset | Somerset | $10,342.20 | $117.23 – $127.45 |
| UPMC St. Margaret | Pittsburgh | $31,450.80 | $80.47 – $140.19 |
| WellSpan Evangelical Community Hospital | Lewisburg | $73,040.40 | $9,678.90 – $40,396.80 |