Lig/band angioaccess av fistula at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$12,573.60
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.
$20,956.00
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.
$912.21 with UPMC Work Partners vs $17,812.60 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $912.21 | ↓ -93% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,656.03 | ↓ -87% |
| Prime Net | Managed Medicare | $2,870.97 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $2,980.85 | ↓ -76% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $2,980.85 | ↓ -76% |
| Humana | Medicare | $3,010.96 | ↓ -76% |
| Aetna | Medicare | $3,140.43 | ↓ -75% |
| Geisinger | Medicare | $3,161.51 | ↓ -75% |
| Cigna | Medicare | $3,161.51 | ↓ -75% |
| United Healthcare | Medicare | $3,221.73 | ↓ -74% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,251.84 | ↓ -74% |
| Capital Blue Cross | Medicare Advantage | $4,191.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $4,191.20 | ↓ -67% |
| Keystone Autism Services | ACAP | $4,817.54 | ↓ -62% |
| UPMC Health Plan | CHIP | $5,168.18 | ↓ -59% |
| Cigna | Commercial | $6,413.00 | ↓ -49% |
| Prime Net | Legacy Commercial | $8,172.84 | ↓ -35% |
| Aetna | ACO | $8,235.71 | ↓ -34% |
| Prime Net | ACO | $8,235.71 | ↓ -34% |
| Highmark BCBS of PA | Community Blue PPO | $8,468.63 | ↓ -33% |
| Highmark BCBS of PA | CHIP - Managed Care | $8,826.93 | ↓ -30% |
| Highmark BCBS of PA | Commercial | $9,409.55 | ↓ -25% |
| Prime Net | NonGateKeeper | $9,744.54 | ↓ -23% |
| Prime Net | GateKeeper | $9,807.41 | ↓ -22% |
| Aetna | Commercial | $9,807.41 | ↓ -22% |
| Capital Blue Cross | CHIP | $11,462.93 | ↓ -9% |
| Keystone Health Plan | Commercial | $11,462.93 | ↓ -9% |
| Capital Blue Cross | Commercial | $11,462.93 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $11,525.80 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $11,525.80 | ↓ -8% |
| Wellspan Population Health | PPO | $13,621.40 | ↑ +8% |
| Geisinger | Commercial | $13,721.99 | ↑ +9% |
| UPMC Health Plan | Commercial | $14,669.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $15,842.74 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $17,812.60 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Lig/band angioaccess av fistula at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $10,110.00 | $871.67 – $13,480.00 |
| UPMC Community Osteopathic | Harrisburg | $12,573.60 | $76.80 – $5,168.18 |
| UPMC Hanover | Hanover | $12,573.60 | $922.25 – $5,168.18 |
| UPMC Lititz | Lititz | $12,573.60 | $912.21 – $5,168.18 |
| UPMC Memorial | York | $12,573.60 | $922.25 – $5,168.18 |
| UPMC Presbyterian | Pittsburgh | $13,630.20 | $931.20 – $3,300.84 |
| UPMC Somerset | Somerset | $12,573.60 | $347.50 – $3,000.76 |
| Uniontown Hospital | Uniontown | $2,299.00 | $205.80 – $6,356.47 |