Perc d-e cor revasc t cabg b at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$9,788.40
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.
$16,314.00
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.
$2,235.02 with Prime Net vs $17,298.00 with Cigna — 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 | $2,235.02 | ↓ -77% |
| Aetna | Medicare | $2,691.81 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $3,262.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $3,262.80 | ↓ -67% |
| Prime Net | Legacy Commercial | $6,362.46 | ↓ -35% |
| Aetna | ACO | $6,411.40 | ↓ -35% |
| Prime Net | ACO | $6,411.40 | ↓ -35% |
| Prime Net | NonGateKeeper | $7,586.01 | ↓ -23% |
| Aetna | Commercial | $7,634.95 | ↓ -22% |
| Prime Net | GateKeeper | $7,634.95 | ↓ -22% |
| UPMC Health Plan | CHIP | $7,873.60 | ↓ -20% |
| Capital Blue Cross | CHIP | $8,923.76 | ↓ -9% |
| Capital Blue Cross | Commercial | $8,923.76 | ↓ -9% |
| Keystone Health Plan | Commercial | $8,923.76 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $8,972.70 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $8,972.70 | ↓ -8% |
| Wellspan Population Health | PPO | $10,604.10 | ↑ +8% |
| Geisinger | Commercial | $10,682.41 | ↑ +9% |
| UPMC Health Plan | Commercial | $11,419.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $12,333.38 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $13,866.90 | ↑ +42% |
| Cigna | Commercial | $17,298.00 | ↑ +77% |
| United Healthcare | Commercial | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Perc d-e cor revasc t cabg b at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $9,616.80 | $2,142.86 – $12,822.40 |
| UPMC Community Osteopathic | Harrisburg | $9,788.40 | $3,262.80 – $13,866.90 |
| UPMC Hamot | Erie | $11,941.20 | $2,142.86 – $2,142.86 |
| UPMC Hanover | Hanover | $9,788.40 | $7,873.60 – $7,873.60 |
| UPMC Jameson | New Castle | $10,473.60 | $2,180.67 – $7,873.60 |
| UPMC Lititz | Lititz | $9,788.40 | $7,873.60 – $7,873.60 |
| UPMC Memorial | York | $9,788.40 | $1,746.52 – $7,873.60 |
| UPMC Mercy | Pittsburgh | $11,088.60 | $2,142.86 – $6,217.33 |