MRI guid ndl plc s&i at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,431.00
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.
$2,385.00
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.
$263.39 with United Healthcare Community Plan for Families vs $2,027.25 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $263.39 | ↓ -82% |
| Prime Net | Managed Medicare | $326.75 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $327.13 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $327.13 | ↓ -77% |
| UPMC Health Plan | Managed Medicaid | $334.85 | ↓ -77% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $350.82 | ↓ -75% |
| Geisinger | Medicaid/CHIP | $375.19 | ↓ -74% |
| Aetna | Medicare | $393.52 | ↓ -73% |
| PA Health & Wellness | PA Medicaid HMO | $438.97 | ↓ -69% |
| Capital Blue Cross | Medicare Advantage | $477.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $477.00 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $750.84 | ↓ -48% |
| Premier Comp Solutions | Worker's Comp | $750.84 | ↓ -48% |
| Prime Net | Legacy Commercial | $930.15 | ↓ -35% |
| Aetna | ACO | $937.30 | ↓ -35% |
| Prime Net | ACO | $937.30 | ↓ -35% |
| Prime Net | NonGateKeeper | $1,109.03 | ↓ -22% |
| Aetna | Commercial | $1,116.18 | ↓ -22% |
| Prime Net | GateKeeper | $1,116.18 | ↓ -22% |
| Capital Blue Cross | Commercial | $1,304.60 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,304.60 | ↓ -9% |
| Capital Blue Cross | CHIP | $1,304.60 | ↓ -9% |
| UPMC Health Plan | CHIP | $1,450.46 | ↑ +1% |
| Wellspan Population Health | PPO | $1,550.25 | ↑ +8% |
| Geisinger | Commercial | $1,561.70 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,669.50 | ↑ +17% |
| United Healthcare | Commercial | $1,755.36 | ↑ +23% |
| Prime Net | FH-Medical Rental | $1,803.06 | ↑ +26% |
| Cigna | Commercial | $1,860.30 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,027.25 | ↑ +42% |
Visitor-reported prices
Comments
MRI guid ndl plc s&i at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,377.60 | $270.46 – $1,836.80 |
| UPMC Community Osteopathic | Harrisburg | $1,431.00 | $263.39 – $2,053.89 |
| UPMC Hanover | Hanover | $1,431.00 | $263.39 – $750.84 |
| UPMC Lititz | Lititz | $1,431.00 | $263.39 – $750.84 |
| UPMC Magee | Pittsburgh | $2,958.60 | $283.34 – $717.47 |
| UPMC Memorial | York | $1,431.00 | $263.39 – $2,260.21 |
| UPMC Somerset | Somerset | $1,431.00 | $231.22 – $717.47 |