Pq biliary strict dil s&i at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2,397.60
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.
$3,996.00
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.
$122.79 with United Healthcare Community Plan for Families vs $3,396.60 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $122.79 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $170.75 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $170.75 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $174.78 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $183.12 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $195.84 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $229.13 | ↓ -90% |
| Prime Net | Managed Medicare | $547.45 | ↓ -77% |
| Premier Comp Solutions | Worker's Comp | $650.33 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $650.33 | ↓ -73% |
| Aetna | Medicare | $659.34 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $799.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $799.20 | ↓ -67% |
| UPMC Health Plan | CHIP | $983.75 | ↓ -59% |
| Prime Net | Legacy Commercial | $1,558.44 | ↓ -35% |
| Aetna | ACO | $1,570.43 | ↓ -34% |
| Prime Net | ACO | $1,570.43 | ↓ -34% |
| Prime Net | NonGateKeeper | $1,858.14 | ↓ -23% |
| Aetna | Commercial | $1,870.13 | ↓ -22% |
| Prime Net | GateKeeper | $1,870.13 | ↓ -22% |
| Keystone Health Plan | Commercial | $2,185.81 | ↓ -9% |
| Capital Blue Cross | CHIP | $2,185.81 | ↓ -9% |
| Capital Blue Cross | Commercial | $2,185.81 | ↓ -9% |
| Wellspan Population Health | PPO | $2,597.40 | ↑ +8% |
| Geisinger | Commercial | $2,616.58 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,797.20 | ↑ +17% |
| United Healthcare | Commercial | $2,941.06 | ↑ +23% |
| Prime Net | FH-Medical Rental | $3,020.98 | ↑ +26% |
| Cigna | Commercial | $3,116.88 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,396.60 | ↑ +42% |
Visitor-reported prices
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Pq biliary strict dil s&i at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $2,397.60 | $122.79 – $3,396.60 |
| UPMC Hamot | Erie | $1,760.40 | $147.90 – $680.49 |
| UPMC Hanover | Hanover | $2,397.60 | $122.79 – $660.20 |
| UPMC Lititz | Lititz | $2,397.60 | $102.93 – $650.33 |
| UPMC Magee | Pittsburgh | $1,707.60 | $113.22 – $680.49 |
| UPMC Memorial | York | $2,397.60 | $102.93 – $1,497.72 |
| UPMC Mercy | Pittsburgh | $1,547.40 | $147.90 – $692.28 |
| UPMC Passavant-McCandless | Pittsburgh | $1,452.60 | $147.90 – $791.27 |