Insertion of new/replacement ppm w/transvenous electrode(s) ventricular at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$24,630.00
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.
$41,050.00
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.
$585.70 with AmeriHealth Caritas vs $34,892.50 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $585.70 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $585.70 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $599.53 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $628.13 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $671.75 | ↓ -97% |
| PA Health & Wellness | PA Medicaid HMO | $785.94 | ↓ -97% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $1,828.26 | ↓ -93% |
| Prime Net | Managed Medicare | $5,623.85 | ↓ -77% |
| UPMC Health Plan | CHIP | $5,721.46 | ↓ -77% |
| Aetna | Medicare | $6,773.25 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $8,210.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $8,210.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $16,009.50 | ↓ -35% |
| Prime Net | ACO | $16,132.65 | ↓ -35% |
| Aetna | ACO | $16,132.65 | ↓ -35% |
| Cigna | Commercial | $17,298.00 | ↓ -30% |
| Prime Net | NonGateKeeper | $19,088.25 | ↓ -23% |
| Prime Net | GateKeeper | $19,211.40 | ↓ -22% |
| Aetna | Commercial | $19,211.40 | ↓ -22% |
| Capital Blue Cross | CHIP | $22,454.35 | ↓ -9% |
| Capital Blue Cross | Commercial | $22,454.35 | ↓ -9% |
| Keystone Health Plan | Commercial | $22,454.35 | ↓ -9% |
| Wellspan Population Health | PPO | $26,682.50 | ↑ +8% |
| Geisinger | Commercial | $26,879.54 | ↑ +9% |
| UPMC Health Plan | Commercial | $28,735.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $31,033.80 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $34,892.50 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $4,138.20 | $461.18 – $5,517.60 |
| UPMC Cole | Coudersport | $990.00 | $457.38 – $1,954.88 |
| UPMC Community Osteopathic | Harrisburg | $24,630.00 | $585.70 – $34,892.50 |
| UPMC East | Monroeville | $3,774.00 | $507.30 – $10,476.31 |
| UPMC Hamot | Erie | $10,378.80 | $507.30 – $14,511.47 |
| UPMC Hanover | Hanover | $24,630.00 | $585.70 – $15,996.05 |
| UPMC Jameson | New Castle | $17,091.00 | $507.30 – $13,469.54 |
| UPMC Lititz | Lititz | $24,630.00 | $511.65 – $1,828.26 |