Porfimer sodium injection at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$13,787.40
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.
$22,979.00
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.
$3,148.12 with Prime Net vs $75,716.24 with Highmark BCBS of PA — 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 | $3,148.12 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $4,595.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $4,595.80 | ↓ -67% |
| Keystone Health Plan | Commercial | $7,376.26 | ↓ -46% |
| Capital Blue Cross | CHIP | $7,376.26 | ↓ -46% |
| Capital Blue Cross | Commercial | $7,376.26 | ↓ -46% |
| Prime Net | Legacy Commercial | $8,961.81 | ↓ -35% |
| Aetna | ACO | $9,030.75 | ↓ -34% |
| Prime Net | ACO | $9,030.75 | ↓ -34% |
| UPMC Work Partners | Workers Comp | $9,357.05 | ↓ -32% |
| Prime Net | NonGateKeeper | $10,685.24 | ↓ -22% |
| Aetna | Commercial | $10,754.17 | ↓ -22% |
| Prime Net | GateKeeper | $10,754.17 | ↓ -22% |
| PA Health & Wellness | PA Medicaid HMO | $12,638.45 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $12,638.45 | ↓ -8% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $13,325.63 | ↓ -3% |
| United Healthcare | Commercial | $14,155.06 | ↑ +3% |
| Wellspan Population Health | PPO | $14,936.35 | ↑ +8% |
| Geisinger | Commercial | $15,046.65 | ↑ +9% |
| UPMC Health Plan | Commercial | $16,085.30 | ↑ +17% |
| UPMC Health Plan | CHIP | $16,085.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $17,372.12 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $19,532.15 | ↑ +42% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $23,986.14 | ↑ +74% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $23,986.14 | ↑ +74% |
| Humana | Medicare | $24,228.42 | ↑ +76% |
| Aetna | Medicare | $25,270.24 | ↑ +83% |
| Cigna | Medicare | $25,439.84 | ↑ +85% |
| Geisinger | Medicare | $25,439.84 | ↑ +85% |
| United Healthcare | Medicare | $25,924.41 | ↑ +88% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $26,166.69 | ↑ +90% |
| Cigna | Commercial | $32,079.05 | ↑ +133% |
| Keystone Autism Services | ACAP | $38,765.47 | ↑ +181% |
| Highmark BCBS of PA | Community Blue PPO | $68,144.85 | ↑ +394% |
| Highmark BCBS of PA | CHIP - Managed Care | $71,028.04 | ↑ +415% |
| Highmark BCBS of PA | Commercial | $75,716.24 | ↑ +449% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Porfimer sodium injection at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $13,787.40 | $4,595.80 – $26,166.69 |
| UPMC Hanover | Hanover | $13,787.40 | $23,986.14 – $38,765.47 |
| UPMC Lititz | Lititz | $13,787.40 | $23,986.14 – $38,765.47 |
| UPMC Magee | Pittsburgh | $105,045.60 | $4,829.04 – $26,166.69 |
| UPMC Memorial | York | $13,787.40 | $3,898.75 – $38,765.47 |
| UPMC Mercy | Pittsburgh | $90,741.60 | $4,783.49 – $26,651.26 |
| UPMC Passavant-McCandless | Pittsburgh | $105,045.60 | $4,829.04 – $26,651.26 |
| UPMC Presbyterian | Pittsburgh | $105,045.60 | $4,829.04 – $26,651.26 |