Mycophenolic acid at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2.40
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.
$4.00
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.
$0.14 with Health Partners Plans (Jefferson Health Plan) vs $1.70 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $0.14 | ↓ -94% |
| Prime Net | Managed Medicare | $0.27 | ↓ -89% |
| Aetna | Medicare | $0.33 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $0.34 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $0.34 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $0.34 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $0.34 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $0.37 | ↓ -85% |
| Keystone Health Plan | Medicare Advantage | $0.40 | ↓ -83% |
| Capital Blue Cross | Medicare Advantage | $0.40 | ↓ -83% |
| UPMC Health Plan | CHIP | $0.41 | ↓ -83% |
| Keystone Health Plan | Commercial | $0.64 | ↓ -73% |
| Capital Blue Cross | CHIP | $0.64 | ↓ -73% |
| Capital Blue Cross | Commercial | $0.64 | ↓ -73% |
| Prime Net | Legacy Commercial | $0.78 | ↓ -68% |
| Prime Net | ACO | $0.79 | ↓ -67% |
| Aetna | ACO | $0.79 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $0.81 | ↓ -66% |
| Cigna | Commercial | $0.89 | ↓ -63% |
| Prime Net | NonGateKeeper | $0.93 | ↓ -61% |
| Prime Net | GateKeeper | $0.94 | ↓ -61% |
| Aetna | Commercial | $0.94 | ↓ -61% |
| United Healthcare | Commercial | $1.23 | ↓ -49% |
| Wellspan Population Health | PPO | $1.30 | ↓ -46% |
| Geisinger | Commercial | $1.31 | ↓ -45% |
| UPMC Health Plan | Commercial | $1.40 | ↓ -42% |
| Prime Net | FH-Medical Rental | $1.51 | ↓ -37% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1.70 | ↓ -29% |
Visitor-reported prices
Comments
Mycophenolic acid at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $20.00 | $0.21 – $20.00 |
| UPMC Community Osteopathic | Harrisburg | $2.40 | $0.14 – $8.26 |
| UPMC East | Monroeville | $29.80 | $0.21 – $29.60 |
| UPMC Hamot | Erie | $37.80 | $0.21 – $1.72 |
| UPMC Northwest | Seneca | $21.60 | $0.21 – $12.88 |
| UPMC Hanover | Hanover | $2.40 | $0.14 – $0.89 |
| UPMC Jameson | New Castle | $36.60 | $0.21 – $5.05 |
| UPMC Lititz | Lititz | $2.40 | $0.14 – $0.89 |