Observation per hour at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$111.60
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.
$186.00
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.
$25.48 with Prime Net vs $3,614.86 with UPMC Health Plan — 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $25.48 | ↓ -77% |
| Aetna | Medicare | $30.69 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $37.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $37.20 | ↓ -67% |
| Prime Net | Legacy Commercial | $72.54 | ↓ -35% |
| Aetna | ACO | $73.10 | ↓ -34% |
| Prime Net | ACO | $73.10 | ↓ -34% |
| Prime Net | NonGateKeeper | $86.49 | ↓ -23% |
| Prime Net | GateKeeper | $87.05 | ↓ -22% |
| Aetna | Commercial | $87.05 | ↓ -22% |
| Capital Blue Cross | Commercial | $101.74 | ↓ -9% |
| Capital Blue Cross | CHIP | $101.74 | ↓ -9% |
| Keystone Health Plan | Commercial | $101.74 | ↓ -9% |
| Wellspan Population Health | PPO | $120.90 | ↑ +8% |
| Geisinger | Commercial | $121.79 | ↑ +9% |
| Cigna | Commercial | $136.34 | ↑ +22% |
| Prime Net | FH-Medical Rental | $140.62 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $158.10 | ↑ +42% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,279.00 | ↑ +1046% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1,300.00 | ↑ +1065% |
| UPMC Health Plan | Managed Medicaid | $1,500.00 | ↑ +1244% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,500.00 | ↑ +1244% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $2,064.00 | ↑ +1749% |
| PA Health & Wellness | PA Medicaid HMO | $2,137.42 | ↑ +1815% |
| Geisinger | Medicaid/CHIP | $2,207.16 | ↑ +1878% |
| UPMC Health Plan | CHIP | $3,000.00 | ↑ +2588% |
| UPMC Health Plan | Commercial | $3,614.86 | ↑ +3139% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Observation per hour at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $86.40 | $27.00 – $2,137.43 |
| UPMC Bedford | Everett | $580.20 | $24.50 – $2,207.16 |
| UPMC Cole | Coudersport | $370.80 | $25.50 – $2,015.60 |
| UPMC Community Osteopathic | Harrisburg | $111.60 | $45.01 – $3,000.00 |
| UPMC East | Monroeville | $516.00 | $27.85 – $2,207.16 |
| UPMC Northwest | Seneca | $443.40 | $1,074.19 – $1,171.85 |
| UPMC Horizon-Greenville | Greenville | $355.80 | $31.88 – $1,074.19 |
| UPMC Jameson | New Castle | $42.00 | $26.56 – $60.88 |