Mapping functional cort/subcort ea add'l hr at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$744.00
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.
?
What you pay up front if you don't use insurance.
$1,240.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$50.03 with Highmark Wholecare (prev Gateway) vs $1,611.00 with United Healthcare — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 Wholecare (prev Gateway) | Medicaid | $50.03 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $50.03 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $51.21 | ↓ -93% |
| United Healthcare Community Plan for Families | PA Medicaid | $51.60 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $53.65 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $57.38 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $67.13 | ↓ -91% |
| Aetna | Medicare | $89.80 | ↓ -88% |
| Prime Net | Managed Medicare | $169.88 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $248.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $248.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $483.60 | ↓ -35% |
| Prime Net | ACO | $487.32 | ↓ -35% |
| Aetna | ACO | $487.32 | ↓ -35% |
| UPMC Health Plan | CHIP | $534.63 | ↓ -28% |
| Prime Net | NonGateKeeper | $576.60 | ↓ -23% |
| Aetna | Commercial | $580.32 | ↓ -22% |
| Prime Net | GateKeeper | $580.32 | ↓ -22% |
| Capital Blue Cross | CHIP | $678.28 | ↓ -9% |
| Keystone Health Plan | Commercial | $678.28 | ↓ -9% |
| Capital Blue Cross | Commercial | $678.28 | ↓ -9% |
| Wellspan Population Health | PPO | $806.00 | ↑ +8% |
| Geisinger | Commercial | $811.95 | ↑ +9% |
| UPMC Health Plan | Commercial | $868.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $937.44 | ↑ +26% |
| Cigna | Commercial | $967.20 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,054.00 | ↑ +42% |
| United Healthcare | Commercial | $1,611.00 | ↑ +117% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Mapping functional cort/subcort ea add'l hr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $744.00 | $50.03 – $1,063.19 |
| UPMC Hanover | Hanover | $744.00 | $50.03 – $1,611.00 |
| UPMC Lititz | Lititz | $744.00 | $50.03 – $1,611.00 |
| UPMC Memorial | York | $744.00 | $50.03 – $1,611.00 |
| UPMC Presbyterian | Pittsburgh | $1,305.00 | $47.27 – $316.81 |
| UPMC Somerset | Somerset | $744.00 | $43.33 – $168.32 |
| UPMC Williamsport | Williamsport | $499.80 | $50.42 – $316.81 |