Opn exc/dstr ntra-abd 5 cm/< at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$6,780.00
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.
?
What you pay up front if you don't use insurance.
$11,300.00
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.
$1,248.41 with UPMC Work Partners vs $9,605.00 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 | $1,248.41 | ↓ -82% |
| Prime Net | Managed Medicare | $1,548.10 | ↓ -77% |
| Aetna | Medicare | $1,864.50 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $2,260.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,260.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $4,407.00 | ↓ -35% |
| Prime Net | ACO | $4,440.90 | ↓ -35% |
| Aetna | ACO | $4,440.90 | ↓ -35% |
| Prime Net | NonGateKeeper | $5,254.50 | ↓ -23% |
| Aetna | Commercial | $5,288.40 | ↓ -22% |
| Prime Net | GateKeeper | $5,288.40 | ↓ -22% |
| Keystone Health Plan | Commercial | $6,181.10 | ↓ -9% |
| Capital Blue Cross | Commercial | $6,181.10 | ↓ -9% |
| Capital Blue Cross | CHIP | $6,181.10 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $6,215.00 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $6,215.00 | ↓ -8% |
| Wellspan Population Health | PPO | $7,345.00 | ↑ +8% |
| Geisinger | Commercial | $7,399.24 | ↑ +9% |
| UPMC Health Plan | CHIP | $7,910.00 | ↑ +17% |
| UPMC Health Plan | Commercial | $7,910.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $8,542.80 | ↑ +26% |
| Cigna | Commercial | $9,539.00 | ↑ +41% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $9,605.00 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Opn exc/dstr ntra-abd 5 cm/< at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $6,780.00 | $1,052.00 – $4,471.00 |
| UPMC Hanover | Hanover | $6,780.00 | $1,248.41 – $1,248.41 |
| UPMC Horizon-Greenville | Greenville | $8,245.80 | $846.15 – $1,192.92 |
| UPMC Lititz | Lititz | $6,780.00 | $1,161.92 – $1,248.41 |
| UPMC Memorial | York | $6,780.00 | $354.49 – $1,248.41 |
| UPMC Presbyterian | Pittsburgh | $15,525.00 | $439.08 – $1,516.93 |
| UPMC Somerset | Somerset | $6,780.00 | $430.54 – $1,192.92 |