Injection, fulvestrant at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$115.80
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.
$193.00
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.
$2.06 with Prime Net vs $21.03 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 | $2.06 | ↓ -98% |
| Capital Blue Cross | Medicare Advantage | $3.00 | ↓ -97% |
| Keystone Health Plan | Medicare Advantage | $3.00 | ↓ -97% |
| Keystone Health Plan | Commercial | $4.82 | ↓ -96% |
| Capital Blue Cross | CHIP | $4.82 | ↓ -96% |
| Capital Blue Cross | Commercial | $4.82 | ↓ -96% |
| Prime Net | Legacy Commercial | $5.85 | ↓ -95% |
| Aetna | ACO | $5.89 | ↓ -95% |
| Prime Net | ACO | $5.89 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $6.11 | ↓ -95% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $6.66 | ↓ -94% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $6.66 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $6.73 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $6.73 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $6.73 | ↓ -94% |
| Humana | Medicare | $6.73 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $6.86 | ↓ -94% |
| Prime Net | NonGateKeeper | $6.97 | ↓ -94% |
| Aetna | Commercial | $7.02 | ↓ -94% |
| Aetna | Medicare | $7.02 | ↓ -94% |
| Prime Net | GateKeeper | $7.02 | ↓ -94% |
| Geisinger | Medicare | $7.07 | ↓ -94% |
| Cigna | Medicare | $7.07 | ↓ -94% |
| United Healthcare | Medicare | $7.20 | ↓ -94% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $7.27 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $7.40 | ↓ -94% |
| UPMC Health Plan | CHIP | $8.28 | ↓ -93% |
| United Healthcare | Commercial | $9.24 | ↓ -92% |
| Wellspan Population Health | PPO | $9.75 | ↓ -92% |
| Geisinger | Commercial | $9.82 | ↓ -92% |
| UPMC Health Plan | Commercial | $10.50 | ↓ -91% |
| Keystone Autism Services | ACAP | $10.77 | ↓ -91% |
| Prime Net | FH-Medical Rental | $11.34 | ↓ -90% |
| Cigna | Commercial | $11.91 | ↓ -90% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $12.75 | ↓ -89% |
| Highmark BCBS of PA | Community Blue PPO | $18.93 | ↓ -84% |
| Highmark BCBS of PA | CHIP - Managed Care | $19.73 | ↓ -83% |
| Highmark BCBS of PA | Commercial | $21.03 | ↓ -82% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Injection, fulvestrant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $477.60 | $4.25 – $477.60 |
| UPMC Cole | Coudersport | $2,398.80 | $6.73 – $3,198.40 |
| UPMC Community Osteopathic | Harrisburg | $115.80 | $3.00 – $12.75 |
| UPMC Hamot | Erie | $584.00 | $4.25 – $18.53 |
| UPMC Northwest | Seneca | $6,048.60 | $4.25 – $7.27 |
| UPMC Hanover | Hanover | $115.80 | $6.66 – $10.77 |
| UPMC Horizon-Greenville | Greenville | $361.80 | $4.25 – $12.63 |
| UPMC Kane | Kane | $1,031.40 | $6.73 – $18.53 |