Ins icd gen exist sgl lead at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$34,428.60
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.
$57,381.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $67,103.62 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $1,226.62 | ↓ -96% |
| UPMC Health Plan | CHIP | $5,168.86 | ↓ -85% |
| Prime Net | Managed Medicare | $7,861.20 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $11,476.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $11,476.20 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $11,809.86 | ↓ -66% |
| Cigna | Commercial | $17,298.00 | ↓ -50% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $21,257.75 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $21,257.75 | ↓ -38% |
| Humana | Medicare | $21,472.47 | ↓ -38% |
| Prime Net | Legacy Commercial | $22,378.59 | ↓ -35% |
| Aetna | Medicare | $22,395.79 | ↓ -35% |
| Cigna | Medicare | $22,546.09 | ↓ -35% |
| Geisinger | Medicare | $22,546.09 | ↓ -35% |
| Aetna | ACO | $22,550.73 | ↓ -35% |
| Prime Net | ACO | $22,550.73 | ↓ -35% |
| United Healthcare | Medicare | $22,975.54 | ↓ -33% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $23,190.27 | ↓ -33% |
| Prime Net | NonGateKeeper | $26,682.17 | ↓ -22% |
| Aetna | Commercial | $26,854.31 | ↓ -22% |
| Prime Net | GateKeeper | $26,854.31 | ↓ -22% |
| Keystone Health Plan | Commercial | $31,387.41 | ↓ -9% |
| Capital Blue Cross | CHIP | $31,387.41 | ↓ -9% |
| Capital Blue Cross | Commercial | $31,387.41 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $31,559.55 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $31,559.55 | ↓ -8% |
| Keystone Autism Services | ACAP | $34,355.95 | ↓ -0% |
| Wellspan Population Health | PPO | $37,297.65 | ↑ +8% |
| Geisinger | Commercial | $37,573.08 | ↑ +9% |
| UPMC Health Plan | Commercial | $40,166.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $43,380.04 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $48,773.85 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $60,393.47 | ↑ +75% |
| Highmark BCBS of PA | CHIP - Managed Care | $62,948.69 | ↑ +83% |
| Highmark BCBS of PA | Commercial | $67,103.62 | ↑ +95% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Ins icd gen exist sgl lead at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $34,428.60 | $1,016.56 – $48,773.85 |
| UPMC East | Monroeville | $6,828.00 | $1,312.26 – $23,111.73 |
| UPMC Hanover | Hanover | $34,428.60 | $1,016.56 – $34,308.56 |
| UPMC Lititz | Lititz | $34,428.60 | $1,016.56 – $34,493.87 |
| UPMC Memorial | York | $34,428.60 | $1,016.56 – $34,437.84 |
| UPMC Mercy | Pittsburgh | $33,033.60 | $1,332.29 – $23,539.72 |
| UPMC Passavant-McCandless | Pittsburgh | $34,386.00 | $1,312.26 – $23,539.72 |
| UPMC Presbyterian | Pittsburgh | $55,021.80 | $931.20 – $23,539.72 |