healthcosts.net
Liver Function Test at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$54.00
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.
$90.00
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.
$8.09 with Highmark BCBS of PA vs $76.50 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $8.09 | ↓ -85% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $8.09 | ↓ -85% |
| Humana | Medicare | $8.17 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $8.45 | ↓ -84% |
| Aetna | Medicare | $8.52 | ↓ -84% |
| Cigna | Medicare | $8.58 | ↓ -84% |
| Geisinger | Medicare | $8.58 | ↓ -84% |
| United Healthcare | Medicare | $8.74 | ↓ -84% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $8.82 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $9.03 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicaid | $11.47 | ↓ -79% |
| UPMC Health Plan | Managed Medicaid | $11.74 | ↓ -78% |
| United Healthcare Community Plan for Families | PA Medicaid | $11.83 | ↓ -78% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $12.30 | ↓ -77% |
| Prime Net | Managed Medicare | $12.33 | ↓ -77% |
| Keystone Autism Services | ACAP | $13.07 | ↓ -76% |
| Geisinger | Medicaid/CHIP | $13.15 | ↓ -76% |
| PA Health & Wellness | PA Medicaid HMO | $15.39 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $18.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $18.00 | ↓ -67% |
| Cigna | Commercial | $21.24 | ↓ -61% |
| Highmark BCBS of PA | Community Blue PPO | $22.98 | ↓ -57% |
| Highmark BCBS of PA | CHIP - Managed Care | $23.95 | ↓ -56% |
| Highmark BCBS of PA | Commercial | $25.53 | ↓ -53% |
| Prime Net | Legacy Commercial | $35.10 | ↓ -35% |
| Aetna | ACO | $35.37 | ↓ -35% |
| Prime Net | ACO | $35.37 | ↓ -35% |
| Prime Net | NonGateKeeper | $41.85 | ↓ -23% |
| Prime Net | GateKeeper | $42.12 | ↓ -22% |
| Aetna | Commercial | $42.12 | ↓ -22% |
| Capital Blue Cross | CHIP | $49.23 | ↓ -9% |
| Keystone Health Plan | Commercial | $49.23 | ↓ -9% |
| Capital Blue Cross | Commercial | $49.23 | ↓ -9% |
| UPMC Health Plan | CHIP | $54.82 | ↑ +2% |
| Wellspan Population Health | PPO | $58.50 | ↑ +8% |
| Geisinger | Commercial | $58.93 | ↑ +9% |
| UPMC Health Plan | Commercial | $63.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $68.04 | ↑ +26% |
| United Healthcare | Commercial | $70.57 | ↑ +31% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $76.50 | ↑ +42% |
Visitor-reported prices
Comments
Liver Function Test at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $168.00 | $8.08 – $224.00 |
| UPMC Passavant-McCandless | Pittsburgh | $201.00 | $7.59 – $267.75 |
| UPMC Hamot | Erie | $321.00 | $8.08 – $374.50 |
| UPMC Altoona | Altoona | $156.00 | $8.08 – $208.00 |
| UPMC Bedford | Everett | $75.00 | $2.95 – $112.50 |
| UPMC Cole | Coudersport | $79.20 | $5.31 – $105.60 |
| UPMC Community Osteopathic | Harrisburg | $54.00 | $8.09 – $63.75 |
| UPMC Hanover | Hanover | $54.00 | $8.09 – $78.30 |