MRI cardiac morph & func wwo IV cont w/stress img at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$4,837.20
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.
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What you pay up front if you don't use insurance.
$8,062.00
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.
$504.11 with United Healthcare Community Plan for Families vs $6,852.70 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $504.11 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $643.69 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $643.69 | ↓ -87% |
| Premier Comp Solutions | Worker's Comp | $650.00 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $658.89 | ↓ -86% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $690.32 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $738.26 | ↓ -85% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $748.23 | ↓ -85% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $748.23 | ↓ -85% |
| Humana | Medicare | $755.79 | ↓ -84% |
| Aetna | Medicare | $788.29 | ↓ -84% |
| Geisinger | Medicare | $793.58 | ↓ -84% |
| Cigna | Medicare | $793.58 | ↓ -84% |
| United Healthcare | Medicare | $808.70 | ↓ -83% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $816.25 | ↓ -83% |
| PA Health & Wellness | PA Medicaid HMO | $863.76 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $1,075.55 | ↓ -78% |
| Prime Net | Managed Medicare | $1,104.49 | ↓ -77% |
| Keystone Autism Services | ACAP | $1,209.26 | ↓ -75% |
| Capital Blue Cross | Medicare Advantage | $1,612.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,612.40 | ↓ -67% |
| UPMC Health Plan | CHIP | $1,723.57 | ↓ -64% |
| Highmark BCBS of PA | Community Blue PPO | $2,125.73 | ↓ -56% |
| Highmark BCBS of PA | CHIP - Managed Care | $2,215.67 | ↓ -54% |
| Highmark BCBS of PA | Commercial | $2,361.92 | ↓ -51% |
| Prime Net | Legacy Commercial | $3,144.18 | ↓ -35% |
| Aetna | ACO | $3,168.37 | ↓ -34% |
| Prime Net | ACO | $3,168.37 | ↓ -34% |
| Cigna | Commercial | $3,578.07 | ↓ -26% |
| Prime Net | NonGateKeeper | $3,748.83 | ↓ -23% |
| Prime Net | GateKeeper | $3,773.02 | ↓ -22% |
| Aetna | Commercial | $3,773.02 | ↓ -22% |
| Keystone Health Plan | Commercial | $4,409.91 | ↓ -9% |
| Capital Blue Cross | CHIP | $4,409.91 | ↓ -9% |
| Capital Blue Cross | Commercial | $4,409.91 | ↓ -9% |
| Wellspan Population Health | PPO | $5,240.30 | ↑ +8% |
| Geisinger | Commercial | $5,279.00 | ↑ +9% |
| UPMC Health Plan | Commercial | $5,643.40 | ↑ +17% |
| United Healthcare | Commercial | $5,933.63 | ↑ +23% |
| Prime Net | FH-Medical Rental | $6,094.87 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $6,852.70 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
MRI cardiac morph & func wwo IV cont w/stress img at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $5,547.60 | $384.82 – $7,396.80 |
| UPMC Community Osteopathic | Harrisburg | $4,837.20 | $504.11 – $6,852.70 |
| UPMC Hamot | Erie | $5,154.60 | $557.52 – $1,027.75 |
| UPMC Hanover | Hanover | $4,837.20 | $504.11 – $1,207.58 |
| UPMC Lititz | Lititz | $4,837.20 | $504.11 – $1,214.11 |
| UPMC Magee | Pittsburgh | $6,359.40 | $501.71 – $1,140.30 |
| UPMC Memorial | York | $4,837.20 | $504.11 – $3,286.50 |
| UPMC Passavant-McCandless | Pittsburgh | $5,311.20 | $478.32 – $1,195.06 |