Mayo avwpr vw factor activity at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$156.00
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.
$260.00
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.
$15.34 with Prime Net vs $148.46 with UPMC Health Plan — 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $15.34 | ↓ -90% |
| Keystone Health Plan | Medicare Advantage | $22.40 | ↓ -86% |
| Capital Blue Cross | Medicare Advantage | $22.40 | ↓ -86% |
| United Healthcare | Commercial | $25.49 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $26.30 | ↓ -83% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $30.55 | ↓ -80% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $30.55 | ↓ -80% |
| Humana | Medicare | $30.86 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $31.91 | ↓ -80% |
| Aetna | Medicare | $32.19 | ↓ -79% |
| Cigna | Medicare | $32.40 | ↓ -79% |
| Geisinger | Medicare | $32.40 | ↓ -79% |
| United Healthcare | Medicare | $33.02 | ↓ -79% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $33.33 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicaid | $33.40 | ↓ -79% |
| UPMC Health Plan | Managed Medicaid | $34.19 | ↓ -78% |
| United Healthcare Community Plan for Families | PA Medicaid | $34.45 | ↓ -78% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $35.82 | ↓ -77% |
| Geisinger | Medicaid/CHIP | $38.31 | ↓ -75% |
| Prime Net | Legacy Commercial | $43.68 | ↓ -72% |
| Aetna | ACO | $44.02 | ↓ -72% |
| Prime Net | ACO | $44.02 | ↓ -72% |
| PA Health & Wellness | PA Medicaid HMO | $44.82 | ↓ -71% |
| Keystone Autism Services | ACAP | $49.38 | ↓ -68% |
| Prime Net | NonGateKeeper | $52.08 | ↓ -67% |
| Aetna | Commercial | $52.42 | ↓ -66% |
| Prime Net | GateKeeper | $52.42 | ↓ -66% |
| Capital Blue Cross | Commercial | $61.26 | ↓ -61% |
| Capital Blue Cross | CHIP | $61.26 | ↓ -61% |
| Keystone Health Plan | Commercial | $61.26 | ↓ -61% |
| Wellspan Population Health | PPO | $72.80 | ↓ -53% |
| Geisinger | Commercial | $73.34 | ↓ -53% |
| UPMC Health Plan | Commercial | $78.40 | ↓ -50% |
| Cigna | Commercial | $80.24 | ↓ -49% |
| Prime Net | FH-Medical Rental | $84.67 | ↓ -46% |
| Highmark BCBS of PA | Community Blue PPO | $86.80 | ↓ -44% |
| Highmark BCBS of PA | CHIP - Managed Care | $90.47 | ↓ -42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $95.20 | ↓ -39% |
| Highmark BCBS of PA | Commercial | $96.44 | ↓ -38% |
| UPMC Health Plan | CHIP | $148.46 | ↓ -5% |
Visitor-reported prices
Comments
Mayo avwpr vw factor activity at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $156.00 | $22.40 – $148.46 |
| UPMC East | Monroeville | $480.00 | $26.30 – $640.00 |
| UPMC Hamot | Erie | $347.40 | $26.30 – $62.29 |
| UPMC Northwest | Seneca | $415.80 | $27.99 – $33.33 |
| UPMC Hanover | Hanover | $156.00 | $25.49 – $49.38 |
| UPMC Horizon-Greenville | Greenville | $255.60 | $26.30 – $57.91 |
| UPMC Jameson | New Castle | $255.60 | $28.93 – $63.39 |
| UPMC Lititz | Lititz | $156.00 | $25.49 – $49.38 |