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Lung Function Test (Spirometry) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$346.20
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.
$577.00
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.
$11.79 with United Healthcare Community Plan for Families vs $490.45 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $11.79 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $19.05 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $19.05 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $19.50 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $20.43 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $21.85 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $25.56 | ↓ -93% |
| UPMC Health Plan | CHIP | $74.54 | ↓ -78% |
| Prime Net | Managed Medicare | $79.05 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $96.53 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $115.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $115.40 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $148.17 | ↓ -57% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $148.17 | ↓ -57% |
| Humana | Medicare | $149.67 | ↓ -57% |
| Aetna | Medicare | $156.11 | ↓ -55% |
| Cigna | Medicare | $157.15 | ↓ -55% |
| Geisinger | Medicare | $157.15 | ↓ -55% |
| United Healthcare | Medicare | $160.15 | ↓ -54% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $161.64 | ↓ -53% |
| United Healthcare | Commercial | $163.00 | ↓ -53% |
| Prime Net | Legacy Commercial | $225.03 | ↓ -35% |
| Aetna | ACO | $226.76 | ↓ -35% |
| Prime Net | ACO | $226.76 | ↓ -35% |
| Keystone Autism Services | ACAP | $239.47 | ↓ -31% |
| Prime Net | NonGateKeeper | $268.31 | ↓ -22% |
| Prime Net | GateKeeper | $270.04 | ↓ -22% |
| Aetna | Commercial | $270.04 | ↓ -22% |
| Capital Blue Cross | CHIP | $315.62 | ↓ -9% |
| Keystone Health Plan | Commercial | $315.62 | ↓ -9% |
| Capital Blue Cross | Commercial | $315.62 | ↓ -9% |
| Wellspan Population Health | PPO | $375.05 | ↑ +8% |
| Geisinger | Commercial | $377.82 | ↑ +9% |
| Cigna | Commercial | $387.00 | ↑ +12% |
| UPMC Health Plan | Commercial | $403.90 | ↑ +17% |
| Highmark BCBS of PA | Community Blue PPO | $420.96 | ↑ +22% |
| Prime Net | FH-Medical Rental | $436.21 | ↑ +26% |
| Highmark BCBS of PA | CHIP - Managed Care | $438.77 | ↑ +27% |
| Highmark BCBS of PA | Commercial | $467.73 | ↑ +35% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $490.45 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lung Function Test (Spirometry) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $171.60 | $16.50 – $243.10 |
| UPMC East | Monroeville | $142.20 | $16.50 – $189.60 |
| UPMC Hamot | Erie | $150.00 | $16.50 – $205.40 |
| UPMC Altoona | Altoona | $199.80 | $9.00 – $266.40 |
| UPMC Bedford | Everett | $171.60 | $15.75 – $257.40 |
| UPMC Cole | Coudersport | $100.20 | $15.75 – $92.23 |
| UPMC Community Osteopathic | Harrisburg | $346.20 | $11.79 – $280.50 |
| UPMC Hanover | Hanover | $346.20 | $11.79 – $501.99 |