Nr lnr acclrtr tx max 5 sessions at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$9,337.20
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.
$15,562.00
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.
$1,270.00 with Highmark Wholecare (prev Gateway) vs $26,132.00 with United Healthcare — 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $1,270.00 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,270.00 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $1,300.00 | ↓ -86% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,310.00 | ↓ -86% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $1,362.00 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $1,456.60 | ↓ -84% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,662.94 | ↓ -82% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,662.94 | ↓ -82% |
| Humana | Medicare | $1,679.74 | ↓ -82% |
| PA Health & Wellness | PA Medicaid HMO | $1,704.20 | ↓ -82% |
| Aetna | Medicare | $1,751.97 | ↓ -81% |
| Cigna | Medicare | $1,763.73 | ↓ -81% |
| Geisinger | Medicare | $1,763.73 | ↓ -81% |
| United Healthcare | Medicare | $1,797.32 | ↓ -81% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,814.12 | ↓ -81% |
| Prime Net | Managed Medicare | $2,131.99 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $2,459.30 | ↓ -74% |
| Keystone Autism Services | ACAP | $2,687.58 | ↓ -71% |
| Keystone Health Plan | Medicare Advantage | $3,112.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $3,112.40 | ↓ -67% |
| Highmark BCBS of PA | Community Blue PPO | $4,724.44 | ↓ -49% |
| Highmark BCBS of PA | CHIP - Managed Care | $4,924.33 | ↓ -47% |
| Highmark BCBS of PA | Commercial | $5,249.36 | ↓ -44% |
| UPMC Health Plan | CHIP | $5,380.26 | ↓ -42% |
| Prime Net | Legacy Commercial | $6,069.18 | ↓ -35% |
| Aetna | ACO | $6,115.87 | ↓ -34% |
| Prime Net | ACO | $6,115.87 | ↓ -34% |
| Prime Net | NonGateKeeper | $7,236.33 | ↓ -23% |
| Aetna | Commercial | $7,283.02 | ↓ -22% |
| Prime Net | GateKeeper | $7,283.02 | ↓ -22% |
| Capital Blue Cross | CHIP | $8,512.41 | ↓ -9% |
| Keystone Health Plan | Commercial | $8,512.41 | ↓ -9% |
| Capital Blue Cross | Commercial | $8,512.41 | ↓ -9% |
| Cigna | Commercial | $9,294.06 | ↓ -0% |
| Wellspan Population Health | PPO | $10,115.30 | ↑ +8% |
| Geisinger | Commercial | $10,190.00 | ↑ +9% |
| UPMC Health Plan | Commercial | $10,893.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $11,764.87 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $13,227.70 | ↑ +42% |
| United Healthcare | Commercial | $26,132.00 | ↑ +180% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Nr lnr acclrtr tx max 5 sessions at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $12,780.60 | $1,000.00 – $17,040.80 |
| UPMC Community Osteopathic | Harrisburg | $9,337.20 | $1,270.00 – $13,227.70 |
| UPMC East | Monroeville | $15,173.40 | $1,100.00 – $20,231.20 |
| UPMC Horizon-Greenville | Greenville | $11,922.60 | $1,100.00 – $3,141.35 |
| UPMC Lititz | Lititz | $9,337.20 | $1,270.00 – $2,698.37 |
| UPMC Magee | Pittsburgh | $12,104.40 | $1,100.00 – $2,763.33 |
| UPMC Memorial | York | $9,337.20 | $1,270.00 – $9,058.44 |
| UPMC Passavant-McCandless | Pittsburgh | $14,978.40 | $1,100.00 – $2,763.33 |