Pq kyphplsty 1 bdy lumb w/img at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$18,813.00
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.
$31,355.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $26,400.15 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 | $1,016.56 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $3,758.61 | ↓ -80% |
| Prime Net | Managed Medicare | $4,255.08 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $6,211.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $6,211.80 | ↓ -67% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $6,765.49 | ↓ -64% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $6,765.49 | ↓ -64% |
| Humana | Medicare | $6,833.83 | ↓ -64% |
| Aetna | Medicare | $7,127.68 | ↓ -62% |
| Cigna | Medicare | $7,175.52 | ↓ -62% |
| Geisinger | Medicare | $7,175.52 | ↓ -62% |
| United Healthcare | Medicare | $7,312.20 | ↓ -61% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $7,380.54 | ↓ -61% |
| Cigna | Commercial | $9,539.00 | ↓ -49% |
| UPMC Work Partners | Workers Comp | $9,896.15 | ↓ -47% |
| Keystone Autism Services | ACAP | $10,934.13 | ↓ -42% |
| UPMC Health Plan | CHIP | $11,433.07 | ↓ -39% |
| Prime Net | Legacy Commercial | $12,113.01 | ↓ -36% |
| Aetna | ACO | $12,206.19 | ↓ -35% |
| Prime Net | ACO | $12,206.19 | ↓ -35% |
| Prime Net | NonGateKeeper | $14,442.43 | ↓ -23% |
| Prime Net | GateKeeper | $14,535.61 | ↓ -23% |
| Aetna | Commercial | $14,535.61 | ↓ -23% |
| Capital Blue Cross | CHIP | $16,989.27 | ↓ -10% |
| Keystone Health Plan | Commercial | $16,989.27 | ↓ -10% |
| Capital Blue Cross | Commercial | $16,989.27 | ↓ -10% |
| PA Health & Wellness | PA Medicaid HMO | $17,082.45 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $17,082.45 | ↓ -9% |
| Highmark BCBS of PA | Community Blue PPO | $19,220.83 | ↑ +2% |
| Highmark BCBS of PA | CHIP - Managed Care | $20,034.06 | ↑ +6% |
| Wellspan Population Health | PPO | $20,188.35 | ↑ +7% |
| Geisinger | Commercial | $20,337.43 | ↑ +8% |
| Highmark BCBS of PA | Commercial | $21,356.40 | ↑ +14% |
| UPMC Health Plan | Commercial | $21,741.30 | ↑ +16% |
| United Healthcare | Commercial | $23,077.28 | ↑ +23% |
| Prime Net | FH-Medical Rental | $23,480.60 | ↑ +25% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $26,400.15 | ↑ +40% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Pq kyphplsty 1 bdy lumb w/img at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $866.40 | $400.28 – $9,456.32 |
| UPMC Community Osteopathic | Harrisburg | $18,813.00 | $1,016.56 – $26,400.15 |
| UPMC East | Monroeville | $24,137.40 | $4,719.92 – $32,183.20 |
| UPMC Hamot | Erie | $17,721.00 | $4,675.40 – $9,905.66 |
| UPMC Hanover | Hanover | $18,813.00 | $1,016.56 – $11,433.07 |
| UPMC Lititz | Lititz | $18,813.00 | $1,016.56 – $11,433.07 |
| UPMC Memorial | York | $18,813.00 | $1,016.56 – $11,433.07 |
| UPMC Passavant-McCandless | Pittsburgh | $7,489.80 | $4,719.92 – $10,995.72 |