Med genetics&genetic counseling svcs each 30 min at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$251.40
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.
$419.00
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.
$44.52 with Prime Net vs $276.25 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $44.52 | ↓ -82% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $47.21 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $47.21 | ↓ -81% |
| UPMC Health Plan | Managed Medicaid | $48.32 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $50.63 | ↓ -80% |
| Aetna | Medicare | $53.62 | ↓ -79% |
| Geisinger | Medicaid/CHIP | $54.14 | ↓ -78% |
| PA Health & Wellness | PA Medicaid HMO | $63.35 | ↓ -75% |
| Keystone Health Plan | Medicare Advantage | $65.00 | ↓ -74% |
| Capital Blue Cross | Medicare Advantage | $65.00 | ↓ -74% |
| Prime Net | Legacy Commercial | $126.75 | ↓ -50% |
| Prime Net | ACO | $127.72 | ↓ -49% |
| Aetna | ACO | $127.72 | ↓ -49% |
| Prime Net | NonGateKeeper | $151.12 | ↓ -40% |
| Prime Net | GateKeeper | $152.10 | ↓ -39% |
| Aetna | Commercial | $152.10 | ↓ -39% |
| Capital Blue Cross | CHIP | $177.78 | ↓ -29% |
| Capital Blue Cross | Commercial | $177.78 | ↓ -29% |
| Keystone Health Plan | Commercial | $177.78 | ↓ -29% |
| Wellspan Population Health | PPO | $211.25 | ↓ -16% |
| Geisinger | Commercial | $212.81 | ↓ -15% |
| UPMC Health Plan | CHIP | $227.50 | ↓ -10% |
| UPMC Health Plan | Commercial | $227.50 | ↓ -10% |
| United Healthcare | Commercial | $239.20 | ↓ -5% |
| Prime Net | FH-Medical Rental | $245.70 | ↓ -2% |
| Cigna | Commercial | $253.50 | ↑ +1% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $276.25 | ↑ +10% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Med genetics&genetic counseling svcs each 30 min at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $251.40 | $47.21 – $276.25 |
| UPMC Magee | Pittsburgh | $138.00 | $40.89 – $63.35 |
| UPMC Memorial | York | $251.40 | $13.33 – $54.14 |
| UPMC Somerset | Somerset | $251.40 | $16.19 – $51.66 |