Opn exc/dst ntra-abd 10.1-20 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$8,653.20
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.
?
What you pay up front if you don't use insurance.
$14,422.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$1,907.19 with UPMC Work Partners vs $12,258.70 with Multiplan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $1,907.19 | ↓ -78% |
| Prime Net | Managed Medicare | $1,975.81 | ↓ -77% |
| Aetna | Medicare | $2,379.63 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $2,884.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,884.40 | ↓ -67% |
| Prime Net | Legacy Commercial | $5,624.58 | ↓ -35% |
| Prime Net | ACO | $5,667.85 | ↓ -34% |
| Aetna | ACO | $5,667.85 | ↓ -34% |
| Prime Net | NonGateKeeper | $6,706.23 | ↓ -23% |
| Prime Net | GateKeeper | $6,749.50 | ↓ -22% |
| Aetna | Commercial | $6,749.50 | ↓ -22% |
| Capital Blue Cross | CHIP | $7,888.83 | ↓ -9% |
| Capital Blue Cross | Commercial | $7,888.83 | ↓ -9% |
| Keystone Health Plan | Commercial | $7,888.83 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $7,932.10 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $7,932.10 | ↓ -8% |
| Wellspan Population Health | PPO | $9,374.30 | ↑ +8% |
| Geisinger | Commercial | $9,443.53 | ↑ +9% |
| Cigna | Commercial | $9,539.00 | ↑ +10% |
| UPMC Health Plan | CHIP | $10,095.40 | ↑ +17% |
| UPMC Health Plan | Commercial | $10,095.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $10,903.03 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $12,258.70 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Opn exc/dst ntra-abd 10.1-20 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $8,653.20 | $1,052.00 – $4,471.00 |
| UPMC Hanover | Hanover | $8,653.20 | $1,907.19 – $1,907.19 |
| UPMC Horizon-Greenville | Greenville | $12,047.40 | $1,292.79 – $1,822.43 |
| UPMC Lititz | Lititz | $8,653.20 | $1,775.20 – $1,907.19 |
| UPMC Memorial | York | $8,653.20 | $541.61 – $1,907.19 |
| UPMC Presbyterian | Pittsburgh | $22,682.40 | $670.85 – $2,319.42 |
| UPMC Somerset | Somerset | $8,653.20 | $657.80 – $1,822.43 |