Ins/rpl ldless pm right vent w img & eval at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$24,161.40
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.
?
What you pay up front if you don't use insurance.
$40,269.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$638.52 with UPMC Work Partners vs $57,013.86 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $638.52 | ↓ -97% |
| Prime Net | Managed Medicare | $5,516.85 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $8,053.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $8,053.80 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $10,034.12 | ↓ -58% |
| United Healthcare Community Plan for Families | PA Medicaid | $13,726.63 | ↓ -43% |
| Prime Net | Legacy Commercial | $15,704.91 | ↓ -35% |
| Aetna | ACO | $15,825.72 | ↓ -34% |
| Prime Net | ACO | $15,825.72 | ↓ -34% |
| Cigna | Commercial | $17,298.00 | ↓ -28% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $18,061.41 | ↓ -25% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $18,061.41 | ↓ -25% |
| Humana | Medicare | $18,243.85 | ↓ -24% |
| Prime Net | NonGateKeeper | $18,725.08 | ↓ -23% |
| Aetna | Commercial | $18,845.89 | ↓ -22% |
| Prime Net | GateKeeper | $18,845.89 | ↓ -22% |
| Aetna | Medicare | $19,028.34 | ↓ -21% |
| Cigna | Medicare | $19,156.04 | ↓ -21% |
| Geisinger | Medicare | $19,156.04 | ↓ -21% |
| United Healthcare | Medicare | $19,520.92 | ↓ -19% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $19,703.36 | ↓ -18% |
| Keystone Health Plan | Commercial | $22,027.14 | ↓ -9% |
| Capital Blue Cross | Commercial | $22,027.14 | ↓ -9% |
| Capital Blue Cross | CHIP | $22,027.14 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $22,147.95 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $22,147.95 | ↓ -8% |
| Wellspan Population Health | PPO | $26,174.85 | ↑ +8% |
| Geisinger | Commercial | $26,368.14 | ↑ +9% |
| UPMC Health Plan | Commercial | $28,188.30 | ↑ +17% |
| UPMC Health Plan | CHIP | $28,188.30 | ↑ +17% |
| Keystone Autism Services | ACAP | $29,190.16 | ↑ +21% |
| Prime Net | FH-Medical Rental | $30,443.36 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $34,228.65 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $51,312.65 | ↑ +112% |
| Highmark BCBS of PA | CHIP - Managed Care | $53,483.67 | ↑ +121% |
| Highmark BCBS of PA | Commercial | $57,013.86 | ↑ +136% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl ldless pm right vent w img & eval at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $15,600.00 | $307.59 – $20,800.00 |
| UPMC Community Osteopathic | Harrisburg | $24,161.40 | $638.52 – $34,228.65 |
| UPMC Hamot | Erie | $17,683.80 | $307.59 – $26,444.52 |
| UPMC Hanover | Hanover | $24,161.40 | $638.52 – $29,149.89 |
| UPMC Lititz | Lititz | $24,161.40 | $638.52 – $29,307.34 |
| UPMC Magee | Pittsburgh | $1,543.20 | $310.52 – $20,000.27 |
| UPMC Memorial | York | $24,161.40 | $250.70 – $29,259.74 |
| UPMC Mercy | Pittsburgh | $16,670.40 | $307.59 – $20,000.27 |