Phlebotomy therapeutic at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$231.00
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.
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What you pay up front if you don't use insurance.
$385.00
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.
$12.70 with AmeriHealth Caritas vs $399.00 with United Healthcare — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $12.70 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $12.70 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $13.00 | ↓ -94% |
| United Healthcare Community Plan for Families | PA Medicaid | $13.10 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $13.62 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $14.57 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $17.04 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $38.35 | ↓ -83% |
| Prime Net | Managed Medicare | $52.74 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $77.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $77.00 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $122.08 | ↓ -47% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $122.08 | ↓ -47% |
| Humana | Medicare | $123.31 | ↓ -47% |
| Aetna | Medicare | $128.61 | ↓ -44% |
| Cigna | Medicare | $129.48 | ↓ -44% |
| Geisinger | Medicare | $129.48 | ↓ -44% |
| United Healthcare | Medicare | $131.94 | ↓ -43% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $133.17 | ↓ -42% |
| Prime Net | Legacy Commercial | $150.15 | ↓ -35% |
| Aetna | ACO | $151.31 | ↓ -34% |
| Prime Net | ACO | $151.31 | ↓ -34% |
| UPMC Health Plan | CHIP | $154.17 | ↓ -33% |
| Prime Net | NonGateKeeper | $179.03 | ↓ -22% |
| Prime Net | GateKeeper | $180.18 | ↓ -22% |
| Aetna | Commercial | $180.18 | ↓ -22% |
| Keystone Autism Services | ACAP | $197.30 | ↓ -15% |
| Capital Blue Cross | CHIP | $210.59 | ↓ -9% |
| Capital Blue Cross | Commercial | $210.59 | ↓ -9% |
| Keystone Health Plan | Commercial | $210.59 | ↓ -9% |
| Wellspan Population Health | PPO | $250.25 | ↑ +8% |
| Geisinger | Commercial | $252.10 | ↑ +9% |
| UPMC Health Plan | Commercial | $269.50 | ↑ +17% |
| Prime Net | FH-Medical Rental | $291.06 | ↑ +26% |
| Cigna | Commercial | $300.30 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $327.25 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $346.82 | ↑ +50% |
| Highmark BCBS of PA | CHIP - Managed Care | $361.50 | ↑ +56% |
| Highmark BCBS of PA | Commercial | $385.36 | ↑ +67% |
| United Healthcare | Commercial | $399.00 | ↑ +73% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Phlebotomy therapeutic at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $261.00 | $10.00 – $348.00 |
| UPMC Bedford | Everett | $250.80 | $10.50 – $376.20 |
| UPMC Cole | Coudersport | $298.20 | $10.50 – $397.60 |
| UPMC Community Osteopathic | Harrisburg | $231.00 | $12.70 – $327.25 |
| UPMC East | Monroeville | $272.40 | $11.00 – $363.20 |
| UPMC Hamot | Erie | $192.00 | $11.00 – $161.87 |
| UPMC Northwest | Seneca | $331.80 | $11.00 – $129.03 |
| UPMC Hanover | Hanover | $231.00 | $12.70 – $197.02 |