Ins/rpl pm w/tv ld atrl at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$25,170.00
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.
$41,950.00
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 $35,657.50 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $1,754.22 | ↓ -93% |
| Prime Net | Managed Medicare | $5,747.15 | ↓ -77% |
| Aetna | Medicare | $6,921.75 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $8,390.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $8,390.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $16,360.50 | ↓ -35% |
| Prime Net | ACO | $16,486.35 | ↓ -35% |
| Aetna | ACO | $16,486.35 | ↓ -35% |
| Cigna | Commercial | $17,298.00 | ↓ -31% |
| Prime Net | NonGateKeeper | $19,506.75 | ↓ -23% |
| Aetna | Commercial | $19,632.60 | ↓ -22% |
| Prime Net | GateKeeper | $19,632.60 | ↓ -22% |
| Keystone Health Plan | Commercial | $22,946.65 | ↓ -9% |
| Capital Blue Cross | Commercial | $22,946.65 | ↓ -9% |
| Capital Blue Cross | CHIP | $22,946.65 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $23,072.50 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $23,072.50 | ↓ -8% |
| Wellspan Population Health | PPO | $27,267.50 | ↑ +8% |
| Geisinger | Commercial | $27,468.86 | ↑ +9% |
| UPMC Health Plan | Commercial | $29,365.00 | ↑ +17% |
| UPMC Health Plan | CHIP | $29,365.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $31,714.20 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $35,657.50 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl pm w/tv ld atrl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $25,170.00 | $1,016.56 – $35,657.50 |
| UPMC East | Monroeville | $3,294.60 | $793.97 – $10,775.64 |
| UPMC Hamot | Erie | $10,378.80 | $786.48 – $14,511.47 |
| UPMC Lititz | Lititz | $25,170.00 | $486.93 – $1,754.22 |
| UPMC Memorial | York | $25,170.00 | $486.93 – $1,766.45 |
| UPMC Passavant-McCandless | Pittsburgh | $15,256.20 | $793.97 – $10,975.18 |
| UPMC Presbyterian | Pittsburgh | $17,949.60 | $793.97 – $10,975.18 |
| UPMC Somerset | Somerset | $25,170.00 | $778.52 – $1,676.25 |