Insert cath pleura with image at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$10,384.20
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.
$17,307.00
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.
$817.33 with AmeriHealth Caritas vs $14,710.95 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $817.33 | ↓ -92% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $1,342.99 | ↓ -87% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,471.19 | ↓ -86% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,471.19 | ↓ -86% |
| Humana | Medicare | $1,486.05 | ↓ -86% |
| Aetna | Medicare | $1,549.95 | ↓ -85% |
| Geisinger | Medicare | $1,560.35 | ↓ -85% |
| Cigna | Medicare | $1,560.35 | ↓ -85% |
| United Healthcare | Medicare | $1,590.07 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,604.93 | ↓ -85% |
| Prime Net | Managed Medicare | $2,371.06 | ↓ -77% |
| Keystone Autism Services | ACAP | $2,377.68 | ↓ -77% |
| Cigna | Commercial | $3,397.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $3,461.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $3,461.40 | ↓ -67% |
| UPMC Health Plan | CHIP | $3,895.92 | ↓ -62% |
| Highmark BCBS of PA | Community Blue PPO | $4,179.66 | ↓ -60% |
| Highmark BCBS of PA | CHIP - Managed Care | $4,356.50 | ↓ -58% |
| Highmark BCBS of PA | Commercial | $4,644.05 | ↓ -55% |
| Prime Net | Legacy Commercial | $6,749.73 | ↓ -35% |
| Aetna | ACO | $6,801.65 | ↓ -35% |
| Prime Net | ACO | $6,801.65 | ↓ -35% |
| Prime Net | NonGateKeeper | $8,047.76 | ↓ -22% |
| Prime Net | GateKeeper | $8,099.68 | ↓ -22% |
| Aetna | Commercial | $8,099.68 | ↓ -22% |
| Capital Blue Cross | CHIP | $9,466.93 | ↓ -9% |
| Keystone Health Plan | Commercial | $9,466.93 | ↓ -9% |
| Capital Blue Cross | Commercial | $9,466.93 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $9,518.85 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $9,518.85 | ↓ -8% |
| Wellspan Population Health | PPO | $11,249.55 | ↑ +8% |
| Geisinger | Commercial | $11,332.62 | ↑ +9% |
| UPMC Health Plan | Commercial | $12,114.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $13,084.09 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $14,710.95 | ↑ +42% |
| 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
Insert cath pleura with image at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,942.80 | $766.66 – $2,590.40 |
| UPMC Bedford | Everett | $2,611.20 | $534.35 – $3,916.80 |
| UPMC Cole | Coudersport | $396.00 | $79.00 – $1,283.30 |
| UPMC Community Osteopathic | Harrisburg | $10,384.20 | $1,016.56 – $14,710.95 |
| UPMC East | Monroeville | $2,764.80 | $773.96 – $3,686.40 |
| UPMC Hamot | Erie | $2,484.60 | $766.66 – $2,154.03 |
| UPMC Northwest | Seneca | $2,320.80 | $1,283.30 – $1,599.50 |
| UPMC Hanover | Hanover | $10,384.20 | $1,016.56 – $3,895.92 |