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Lower Back (Lumbar Spine) MRI (without contrast) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,656.00
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.
$2,760.00
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.
$228.92 with Highmark BCBS of PA vs $2,346.00 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 | $228.92 | ↓ -86% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $228.92 | ↓ -86% |
| Humana | Medicare | $231.23 | ↓ -86% |
| Aetna | Medicare | $241.17 | ↓ -85% |
| Cigna | Medicare | $242.79 | ↓ -85% |
| Geisinger | Medicare | $242.79 | ↓ -85% |
| United Healthcare Community Plan for Families | PA Medicaid | $245.23 | ↓ -85% |
| United Healthcare | Medicare | $247.42 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $249.73 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $325.31 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $325.31 | ↓ -80% |
| UPMC Health Plan | Managed Medicaid | $333.00 | ↓ -80% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $348.88 | ↓ -79% |
| Keystone Autism Services | ACAP | $369.97 | ↓ -78% |
| Geisinger | Medicaid/CHIP | $373.11 | ↓ -77% |
| Prime Net | Managed Medicare | $378.12 | ↓ -77% |
| OneCall | Worker's Comp | $400.00 | ↓ -76% |
| Premier Comp Solutions | Worker's Comp | $425.00 | ↓ -74% |
| PA Health & Wellness | PA Medicaid HMO | $436.53 | ↓ -74% |
| Keystone Health Plan | Medicare Advantage | $552.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $552.00 | ↓ -67% |
| Highmark BCBS of PA | Community Blue PPO | $650.36 | ↓ -61% |
| Highmark BCBS of PA | CHIP - Managed Care | $677.87 | ↓ -59% |
| Highmark BCBS of PA | Commercial | $722.62 | ↓ -56% |
| Prime Net | Legacy Commercial | $1,076.40 | ↓ -35% |
| Aetna | ACO | $1,084.68 | ↓ -35% |
| Prime Net | ACO | $1,084.68 | ↓ -35% |
| Cigna | Commercial | $1,224.77 | ↓ -26% |
| Prime Net | NonGateKeeper | $1,283.40 | ↓ -23% |
| UPMC Work Partners | Workers Comp | $1,285.02 | ↓ -22% |
| Prime Net | GateKeeper | $1,291.68 | ↓ -22% |
| Aetna | Commercial | $1,291.68 | ↓ -22% |
| Capital Blue Cross | CHIP | $1,509.72 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,509.72 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,509.72 | ↓ -9% |
| Wellspan Population Health | PPO | $1,794.00 | ↑ +8% |
| Geisinger | Commercial | $1,807.25 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,932.00 | ↑ +17% |
| UPMC Health Plan | CHIP | $1,948.86 | ↑ +18% |
| United Healthcare | Commercial | $2,031.36 | ↑ +23% |
| Prime Net | FH-Medical Rental | $2,086.56 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,346.00 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) MRI (without contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,801.60 | $214.16 – $5,385.60 |
| UPMC East | Monroeville | $3,940.80 | $231.07 – $5,254.40 |
| UPMC Hamot | Erie | $1,623.00 | $183.52 – $1,893.50 |
| UPMC Horizon-Greenville | Greenville | $4,861.20 | $206.32 – $6,886.70 |
| UPMC Jameson | New Castle | $1,519.80 | $197.92 – $2,229.04 |
| UPMC Kane | Kane | $2,338.80 | $93.80 – $1,227.91 |
| UPMC McKeesport | Mckeesport | $3,834.60 | $213.60 – $5,432.35 |
| UPMC Bedford | Everett | $1,705.20 | $83.15 – $2,557.80 |