Mayo analysis gene smn1 dosage/deletion at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$792.60
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.
$1,321.00
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.
$109.60 with AmeriHealth Caritas vs $1,122.85 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $109.60 | ↓ -86% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $135.63 | ↓ -83% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $135.63 | ↓ -83% |
| Humana | Medicare | $137.00 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicaid | $139.19 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $141.70 | ↓ -82% |
| UPMC Health Plan | Managed Medicaid | $142.48 | ↓ -82% |
| Aetna | Medicare | $142.89 | ↓ -82% |
| United Healthcare Community Plan for Families | PA Medicaid | $143.58 | ↓ -82% |
| Geisinger | Medicare | $143.85 | ↓ -82% |
| Cigna | Medicare | $143.85 | ↓ -82% |
| United Healthcare | Medicare | $146.59 | ↓ -82% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $147.96 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $149.28 | ↓ -81% |
| Geisinger | Medicaid/CHIP | $159.64 | ↓ -80% |
| Prime Net | Managed Medicare | $180.98 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $186.78 | ↓ -76% |
| Keystone Autism Services | ACAP | $219.20 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $264.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $264.20 | ↓ -67% |
| Cigna | Commercial | $356.20 | ↓ -55% |
| Highmark BCBS of PA | Community Blue PPO | $385.33 | ↓ -51% |
| Highmark BCBS of PA | CHIP - Managed Care | $401.63 | ↓ -49% |
| Highmark BCBS of PA | Commercial | $428.14 | ↓ -46% |
| Prime Net | Legacy Commercial | $515.19 | ↓ -35% |
| Prime Net | ACO | $519.15 | ↓ -35% |
| Aetna | ACO | $519.15 | ↓ -35% |
| Prime Net | NonGateKeeper | $614.26 | ↓ -23% |
| Aetna | Commercial | $618.23 | ↓ -22% |
| Prime Net | GateKeeper | $618.23 | ↓ -22% |
| Capital Blue Cross | Commercial | $722.59 | ↓ -9% |
| Capital Blue Cross | CHIP | $722.59 | ↓ -9% |
| Keystone Health Plan | Commercial | $722.59 | ↓ -9% |
| Wellspan Population Health | PPO | $858.65 | ↑ +8% |
| Geisinger | Commercial | $864.99 | ↑ +9% |
| UPMC Health Plan | Commercial | $924.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $998.68 | ↑ +26% |
| UPMC Health Plan | CHIP | $1,004.36 | ↑ +27% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,122.85 | ↑ +42% |
Visitor-reported prices
Comments
Mayo analysis gene smn1 dosage/deletion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,430.60 | $83.66 – $489.60 |
| UPMC Bedford | Everett | $2,547.60 | $49.43 – $556.20 |
| UPMC Community Osteopathic | Harrisburg | $792.60 | $109.60 – $1,122.85 |
| UPMC East | Monroeville | $2,547.60 | $84.46 – $494.40 |
| UPMC Hamot | Erie | $1,301.40 | $83.66 – $152.33 |
| UPMC Northwest | Seneca | $2,547.60 | $120.56 – $147.96 |
| UPMC Hanover | Hanover | $792.60 | $109.60 – $219.20 |
| UPMC Horizon-Greenville | Greenville | $1,261.80 | $109.60 – $152.33 |