MRI breast without cont bi at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$480.60
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.
$801.00
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.
$109.74 with Prime Net vs $1,224.77 with Cigna — 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 | $109.74 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $160.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $160.20 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $174.32 | ↓ -64% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $228.92 | ↓ -52% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $228.92 | ↓ -52% |
| Humana | Medicare | $231.23 | ↓ -52% |
| Aetna | Medicare | $241.17 | ↓ -50% |
| Cigna | Medicare | $242.79 | ↓ -49% |
| Geisinger | Medicare | $242.79 | ↓ -49% |
| United Healthcare | Medicare | $247.42 | ↓ -49% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $249.73 | ↓ -48% |
| Highmark Wholecare (prev Gateway) | Medicaid | $251.21 | ↓ -48% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $251.21 | ↓ -48% |
| UPMC Health Plan | Managed Medicaid | $257.14 | ↓ -46% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $269.40 | ↓ -44% |
| Geisinger | Medicaid/CHIP | $288.12 | ↓ -40% |
| Prime Net | Legacy Commercial | $312.39 | ↓ -35% |
| UPMC Work Partners | Workers Comp | $313.45 | ↓ -35% |
| Aetna | ACO | $314.79 | ↓ -35% |
| Prime Net | ACO | $314.79 | ↓ -35% |
| PA Health & Wellness | PA Medicaid HMO | $337.09 | ↓ -30% |
| Keystone Autism Services | ACAP | $369.97 | ↓ -23% |
| Prime Net | NonGateKeeper | $372.46 | ↓ -23% |
| Aetna | Commercial | $374.87 | ↓ -22% |
| Prime Net | GateKeeper | $374.87 | ↓ -22% |
| Premier Comp Solutions | Worker's Comp | $425.00 | ↓ -12% |
| Capital Blue Cross | CHIP | $438.15 | ↓ -9% |
| Capital Blue Cross | Commercial | $438.15 | ↓ -9% |
| Keystone Health Plan | Commercial | $438.15 | ↓ -9% |
| Wellspan Population Health | PPO | $520.65 | ↑ +8% |
| Geisinger | Commercial | $524.49 | ↑ +9% |
| UPMC Health Plan | Commercial | $560.70 | ↑ +17% |
| United Healthcare | Commercial | $589.54 | ↑ +23% |
| Prime Net | FH-Medical Rental | $605.56 | ↑ +26% |
| Highmark BCBS of PA | Community Blue PPO | $650.36 | ↑ +35% |
| Highmark BCBS of PA | CHIP - Managed Care | $677.87 | ↑ +41% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $680.85 | ↑ +42% |
| UPMC Health Plan | CHIP | $703.14 | ↑ +46% |
| Highmark BCBS of PA | Commercial | $722.62 | ↑ +50% |
| Cigna | Commercial | $1,224.77 | ↑ +155% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
MRI breast without cont bi at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,316.80 | $101.58 – $4,422.40 |
| UPMC Cole | Coudersport | $2,153.40 | $207.69 – $2,871.20 |
| UPMC Community Osteopathic | Harrisburg | $480.60 | $160.20 – $703.14 |
| UPMC Hamot | Erie | $6,276.00 | $101.58 – $345.98 |
| UPMC Northwest | Seneca | $2,913.60 | $209.00 – $299.52 |
| UPMC Hanover | Hanover | $480.60 | $174.32 – $425.00 |
| UPMC Horizon-Greenville | Greenville | $5,664.00 | $197.63 – $299.52 |
| UPMC Lititz | Lititz | $480.60 | $174.32 – $425.00 |