Pr biopsy skin punch single lesion at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$690.60
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.
$1,151.00
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.
$51.35 with AmeriHealth Caritas vs $1,194.41 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $51.35 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $51.35 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $52.56 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $55.07 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $58.89 | ↓ -91% |
| PA Health & Wellness | PA Medicaid HMO | $68.90 | ↓ -90% |
| Prime Net | Managed Medicare | $137.00 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $153.45 | ↓ -78% |
| Capital Blue Cross | Medicare Advantage | $200.00 | ↓ -71% |
| Keystone Health Plan | Medicare Advantage | $200.00 | ↓ -71% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $378.38 | ↓ -45% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $378.38 | ↓ -45% |
| Humana | Medicare | $382.20 | ↓ -45% |
| Prime Net | Legacy Commercial | $390.00 | ↓ -44% |
| Aetna | ACO | $393.00 | ↓ -43% |
| Prime Net | ACO | $393.00 | ↓ -43% |
| Aetna | Medicare | $398.63 | ↓ -42% |
| Geisinger | Medicare | $401.31 | ↓ -42% |
| Cigna | Medicare | $401.31 | ↓ -42% |
| United Healthcare | Medicare | $408.95 | ↓ -41% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $412.78 | ↓ -40% |
| Prime Net | NonGateKeeper | $465.00 | ↓ -33% |
| Prime Net | GateKeeper | $468.00 | ↓ -32% |
| Aetna | Commercial | $468.00 | ↓ -32% |
| Keystone Health Plan | Commercial | $547.00 | ↓ -21% |
| Capital Blue Cross | Commercial | $547.00 | ↓ -21% |
| Capital Blue Cross | CHIP | $547.00 | ↓ -21% |
| Keystone Autism Services | ACAP | $611.52 | ↓ -11% |
| Wellspan Population Health | PPO | $650.00 | ↓ -6% |
| Geisinger | Commercial | $654.80 | ↓ -5% |
| UPMC Health Plan | CHIP | $661.75 | ↓ -4% |
| UPMC Health Plan | Commercial | $700.00 | ↑ +1% |
| Prime Net | FH-Medical Rental | $756.00 | ↑ +9% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $850.00 | ↑ +23% |
| Cigna | Commercial | $897.78 | ↑ +30% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +47% |
| Highmark BCBS of PA | Community Blue PPO | $1,074.98 | ↑ +56% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,120.46 | ↑ +62% |
| Highmark BCBS of PA | Commercial | $1,194.41 | ↑ +73% |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Pr biopsy skin punch single lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $613.80 | $40.43 – $818.40 |
| UPMC Bedford | Everett | $1,385.40 | $42.45 – $2,078.10 |
| UPMC Cole | Coudersport | $478.20 | $36.59 – $2,094.25 |
| UPMC Community Osteopathic | Harrisburg | $690.60 | $51.35 – $1,016.56 |
| UPMC East | Monroeville | $823.80 | $44.47 – $1,098.40 |
| UPMC Hamot | Erie | $857.40 | $44.47 – $554.00 |
| UPMC Northwest | Seneca | $658.20 | $44.47 – $399.94 |
| UPMC Hanover | Hanover | $690.60 | $51.35 – $1,016.56 |