Pegloticase 8 mg/ml intravenous solution at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$17,178.60
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.
$28,631.00
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.
$1,918.00 with Prime Net vs $11,900.00 with Multiplan — 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 | $1,918.00 | ↓ -89% |
| Capital Blue Cross | Medicare Advantage | $2,800.00 | ↓ -84% |
| Keystone Health Plan | Medicare Advantage | $2,800.00 | ↓ -84% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $3,624.22 | ↓ -79% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $3,624.22 | ↓ -79% |
| Geisinger | Medicaid/CHIP | $3,660.83 | ↓ -79% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $3,660.83 | ↓ -79% |
| PA Health & Wellness | PA Medicaid HMO | $3,660.83 | ↓ -79% |
| Humana | Medicare | $3,660.83 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicaid | $3,734.05 | ↓ -78% |
| Aetna | Medicare | $3,818.25 | ↓ -78% |
| Geisinger | Medicare | $3,843.87 | ↓ -78% |
| Cigna | Medicare | $3,843.87 | ↓ -78% |
| United Healthcare | Medicare | $3,917.09 | ↓ -77% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,953.70 | ↓ -77% |
| UPMC Health Plan | Managed Medicaid | $4,026.92 | ↓ -77% |
| Capital Blue Cross | Commercial | $4,494.00 | ↓ -74% |
| Capital Blue Cross | CHIP | $4,494.00 | ↓ -74% |
| Keystone Health Plan | Commercial | $4,494.00 | ↓ -74% |
| UPMC Health Plan | CHIP | $4,502.83 | ↓ -74% |
| Cigna | Commercial | $4,753.22 | ↓ -72% |
| Prime Net | Legacy Commercial | $5,460.00 | ↓ -68% |
| Aetna | ACO | $5,502.00 | ↓ -68% |
| Prime Net | ACO | $5,502.00 | ↓ -68% |
| UPMC Work Partners | Workers Comp | $5,700.80 | ↓ -67% |
| Keystone Autism Services | ACAP | $5,857.33 | ↓ -66% |
| Prime Net | NonGateKeeper | $6,510.00 | ↓ -62% |
| Aetna | Commercial | $6,552.00 | ↓ -62% |
| Prime Net | GateKeeper | $6,552.00 | ↓ -62% |
| United Healthcare | Commercial | $8,624.00 | ↓ -50% |
| Wellspan Population Health | PPO | $9,100.00 | ↓ -47% |
| Geisinger | Commercial | $9,167.20 | ↓ -47% |
| UPMC Health Plan | Commercial | $9,800.00 | ↓ -43% |
| Highmark BCBS of PA | Community Blue PPO | $10,296.45 | ↓ -40% |
| Prime Net | FH-Medical Rental | $10,584.00 | ↓ -38% |
| Highmark BCBS of PA | CHIP - Managed Care | $10,732.09 | ↓ -38% |
| Highmark BCBS of PA | Commercial | $11,440.46 | ↓ -33% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $11,900.00 | ↓ -31% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Pegloticase 8 mg/ml intravenous solution at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $76,549.80 | $3,660.83 – $102,066.40 |
| UPMC Community Osteopathic | Harrisburg | $17,178.60 | $695.08 – $11,900.00 |
| UPMC Hamot | Erie | $5,918.40 | $417.45 – $3,953.70 |
| UPMC Hanover | Hanover | $17,178.60 | $3,624.22 – $5,857.33 |
| UPMC Horizon-Greenville | Greenville | $6,349.20 | $1,063.90 – $3,953.70 |
| UPMC Lititz | Lititz | $17,178.60 | $3,624.22 – $5,857.33 |
| UPMC Memorial | York | $17,178.60 | $340.24 – $5,857.33 |
| UPMC Mercy | Pittsburgh | $6,349.20 | $417.45 – $4,026.91 |