Noninv pace analysis at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,002.00
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.
$1,670.00
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.
$58.06 with United Healthcare Community Plan for Families vs $17,298.00 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $58.06 | ↓ -94% |
| Prime Net | Managed Medicare | $228.79 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $284.03 | ↓ -72% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $284.03 | ↓ -72% |
| Humana | Medicare | $286.90 | ↓ -71% |
| Aetna | Medicare | $299.24 | ↓ -70% |
| Cigna | Medicare | $301.25 | ↓ -70% |
| Geisinger | Medicare | $301.25 | ↓ -70% |
| United Healthcare | Medicare | $306.98 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $309.85 | ↓ -69% |
| Keystone Health Plan | Medicare Advantage | $334.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $334.00 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $375.44 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicaid | $375.44 | ↓ -63% |
| UPMC Health Plan | Managed Medicaid | $384.31 | ↓ -62% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $402.63 | ↓ -60% |
| Geisinger | Medicaid/CHIP | $430.60 | ↓ -57% |
| Keystone Autism Services | ACAP | $459.04 | ↓ -54% |
| PA Health & Wellness | PA Medicaid HMO | $503.80 | ↓ -50% |
| Prime Net | Legacy Commercial | $651.30 | ↓ -35% |
| Prime Net | ACO | $656.31 | ↓ -35% |
| Aetna | ACO | $656.31 | ↓ -35% |
| Prime Net | NonGateKeeper | $776.55 | ↓ -23% |
| Prime Net | GateKeeper | $781.56 | ↓ -22% |
| Aetna | Commercial | $781.56 | ↓ -22% |
| Highmark BCBS of PA | Community Blue PPO | $806.93 | ↓ -19% |
| Highmark BCBS of PA | CHIP - Managed Care | $841.08 | ↓ -16% |
| Highmark BCBS of PA | Commercial | $896.59 | ↓ -11% |
| Capital Blue Cross | CHIP | $913.49 | ↓ -9% |
| Keystone Health Plan | Commercial | $913.49 | ↓ -9% |
| Capital Blue Cross | Commercial | $913.49 | ↓ -9% |
| UPMC Health Plan | CHIP | $1,038.46 | ↑ +4% |
| UPMC Work Partners | Workers Comp | $1,056.58 | ↑ +5% |
| Wellspan Population Health | PPO | $1,085.50 | ↑ +8% |
| Geisinger | Commercial | $1,093.52 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,169.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,262.52 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,419.50 | ↑ +42% |
| Cigna | Commercial | $17,298.00 | ↑ +1626% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Noninv pace analysis at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $1,002.00 | $58.06 – $1,419.50 |
| UPMC Hamot | Erie | $2,135.40 | $325.18 – $1,085.97 |
| UPMC Hanover | Hanover | $1,002.00 | $58.06 – $1,070.46 |
| UPMC Lititz | Lititz | $1,002.00 | $58.06 – $1,056.58 |
| UPMC Memorial | York | $1,002.00 | $58.06 – $1,070.46 |
| UPMC Somerset | Somerset | $1,002.00 | $50.97 – $1,009.62 |
| WellSpan Chambersburg Hospital | Chambersburg | $1,812.80 | $55.40 – $2,587.00 |