Mayo antithrombin iii antigen at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$55.20
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.
?
What you pay up front if you don't use insurance.
$92.00
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.
$10.70 with Highmark BCBS of PA vs $93.24 with UPMC Health Plan — 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 BCBS of PA | Freedom Blue Medicare Advantage | $10.70 | ↓ -81% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $10.70 | ↓ -81% |
| Humana | Medicare | $10.81 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $11.19 | ↓ -80% |
| Aetna | Medicare | $11.27 | ↓ -80% |
| Geisinger | Medicare | $11.35 | ↓ -79% |
| Cigna | Medicare | $11.35 | ↓ -79% |
| United Healthcare | Medicare | $11.57 | ↓ -79% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11.67 | ↓ -79% |
| Prime Net | Managed Medicare | $12.60 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $14.95 | ↓ -73% |
| Keystone Autism Services | ACAP | $17.30 | ↓ -69% |
| United Healthcare | Commercial | $17.56 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $18.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $18.40 | ↓ -67% |
| Highmark Wholecare (prev Gateway) | Medicaid | $18.99 | ↓ -66% |
| UPMC Health Plan | Managed Medicaid | $19.43 | ↓ -65% |
| United Healthcare Community Plan for Families | PA Medicaid | $19.58 | ↓ -65% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $20.36 | ↓ -63% |
| Geisinger | Medicaid/CHIP | $21.78 | ↓ -61% |
| PA Health & Wellness | PA Medicaid HMO | $25.48 | ↓ -54% |
| Cigna | Commercial | $28.12 | ↓ -49% |
| Highmark BCBS of PA | Community Blue PPO | $30.40 | ↓ -45% |
| Highmark BCBS of PA | CHIP - Managed Care | $31.69 | ↓ -43% |
| Highmark BCBS of PA | Commercial | $33.78 | ↓ -39% |
| Prime Net | Legacy Commercial | $35.88 | ↓ -35% |
| Prime Net | ACO | $36.16 | ↓ -34% |
| Aetna | ACO | $36.16 | ↓ -34% |
| Prime Net | NonGateKeeper | $42.78 | ↓ -23% |
| Aetna | Commercial | $43.06 | ↓ -22% |
| Prime Net | GateKeeper | $43.06 | ↓ -22% |
| Capital Blue Cross | Commercial | $50.32 | ↓ -9% |
| Capital Blue Cross | CHIP | $50.32 | ↓ -9% |
| Keystone Health Plan | Commercial | $50.32 | ↓ -9% |
| Wellspan Population Health | PPO | $59.80 | ↑ +8% |
| Geisinger | Commercial | $60.24 | ↑ +9% |
| UPMC Health Plan | Commercial | $64.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $69.55 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $78.20 | ↑ +42% |
| UPMC Health Plan | CHIP | $93.24 | ↑ +69% |
Visitor-reported prices
Comments
Mayo antithrombin iii antigen at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $146.40 | $10.69 – $195.20 |
| UPMC Bedford | Everett | $178.20 | $3.90 – $267.30 |
| UPMC Community Osteopathic | Harrisburg | $55.20 | $10.70 – $93.24 |
| UPMC East | Monroeville | $127.80 | $10.69 – $170.40 |
| UPMC Hamot | Erie | $172.80 | $10.69 – $29.39 |
| UPMC Northwest | Seneca | $97.20 | $9.80 – $17.19 |
| UPMC Hanover | Hanover | $55.20 | $10.70 – $20.36 |
| UPMC Horizon-Greenville | Greenville | $102.60 | $9.68 – $20.78 |