Mayo nickel at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$89.40
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.
$149.00
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.
$11.00 with AmeriHealth Caritas vs $141.46 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $11.00 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $13.97 | ↓ -84% |
| UPMC Health Plan | Managed Medicaid | $14.30 | ↓ -84% |
| United Healthcare Community Plan for Families | PA Medicaid | $14.41 | ↓ -84% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $14.98 | ↓ -83% |
| Geisinger | Medicaid/CHIP | $16.02 | ↓ -82% |
| PA Health & Wellness | PA Medicaid HMO | $18.75 | ↓ -79% |
| Prime Net | Managed Medicare | $20.41 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $24.26 | ↓ -73% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $24.26 | ↓ -73% |
| Humana | Medicare | $24.51 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $25.35 | ↓ -72% |
| Aetna | Medicare | $25.56 | ↓ -71% |
| Geisinger | Medicare | $25.74 | ↓ -71% |
| Cigna | Medicare | $25.74 | ↓ -71% |
| United Healthcare | Medicare | $26.23 | ↓ -71% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $26.47 | ↓ -70% |
| Capital Blue Cross | Medicare Advantage | $29.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $29.80 | ↓ -67% |
| Keystone Autism Services | ACAP | $39.22 | ↓ -56% |
| Prime Net | Legacy Commercial | $58.11 | ↓ -35% |
| Prime Net | ACO | $58.56 | ↓ -34% |
| Aetna | ACO | $58.56 | ↓ -34% |
| Cigna | Commercial | $63.72 | ↓ -29% |
| Highmark BCBS of PA | Community Blue PPO | $68.94 | ↓ -23% |
| Prime Net | NonGateKeeper | $69.28 | ↓ -23% |
| Aetna | Commercial | $69.73 | ↓ -22% |
| Prime Net | GateKeeper | $69.73 | ↓ -22% |
| Highmark BCBS of PA | CHIP - Managed Care | $71.85 | ↓ -20% |
| Highmark BCBS of PA | Commercial | $76.60 | ↓ -14% |
| Capital Blue Cross | CHIP | $81.50 | ↓ -9% |
| Capital Blue Cross | Commercial | $81.50 | ↓ -9% |
| Keystone Health Plan | Commercial | $81.50 | ↓ -9% |
| Wellspan Population Health | PPO | $96.85 | ↑ +8% |
| Geisinger | Commercial | $97.57 | ↑ +9% |
| UPMC Health Plan | Commercial | $104.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $112.64 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $126.65 | ↑ +42% |
| UPMC Health Plan | CHIP | $141.46 | ↑ +58% |
Visitor-reported prices
Comments
Mayo nickel at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $253.20 | $11.00 – $337.60 |
| UPMC Bedford | Everett | $321.00 | $8.84 – $481.50 |
| UPMC Community Osteopathic | Harrisburg | $89.40 | $11.00 – $141.46 |
| UPMC Northwest | Seneca | $175.20 | $12.10 – $25.74 |
| UPMC Hanover | Hanover | $89.40 | $11.00 – $39.22 |
| UPMC Horizon-Greenville | Greenville | $179.40 | $11.00 – $45.99 |
| UPMC Jameson | New Castle | $179.40 | $12.10 – $52.11 |
| UPMC Kane | Kane | $146.40 | $12.10 – $105.79 |