Pr egd flexible transoral w/placement percutaneous gastrostomy tube at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2,361.00
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.
$3,935.00
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.
$539.10 with Prime Net vs $5,671.12 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 | $539.10 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $787.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $787.00 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $998.09 | ↓ -58% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -57% |
| UPMC Work Partners | Workers Comp | $1,067.72 | ↓ -55% |
| Prime Net | Legacy Commercial | $1,534.65 | ↓ -35% |
| Aetna | ACO | $1,546.45 | ↓ -35% |
| Prime Net | ACO | $1,546.45 | ↓ -35% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,796.55 | ↓ -24% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,796.55 | ↓ -24% |
| Humana | Medicare | $1,814.70 | ↓ -23% |
| Prime Net | NonGateKeeper | $1,829.78 | ↓ -22% |
| Aetna | Commercial | $1,841.58 | ↓ -22% |
| Prime Net | GateKeeper | $1,841.58 | ↓ -22% |
| Aetna | Medicare | $1,892.73 | ↓ -20% |
| Cigna | Medicare | $1,905.43 | ↓ -19% |
| Geisinger | Medicare | $1,905.43 | ↓ -19% |
| United Healthcare | Medicare | $1,941.73 | ↓ -18% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,959.88 | ↓ -17% |
| Capital Blue Cross | CHIP | $2,152.45 | ↓ -9% |
| Capital Blue Cross | Commercial | $2,152.45 | ↓ -9% |
| Keystone Health Plan | Commercial | $2,152.45 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $2,164.25 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $2,164.25 | ↓ -8% |
| UPMC Health Plan | CHIP | $2,315.66 | ↓ -2% |
| Wellspan Population Health | PPO | $2,557.75 | ↑ +8% |
| Geisinger | Commercial | $2,576.64 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,754.50 | ↑ +17% |
| Keystone Autism Services | ACAP | $2,903.52 | ↑ +23% |
| Prime Net | FH-Medical Rental | $2,974.86 | ↑ +26% |
| Cigna | Commercial | $3,069.30 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,344.75 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $5,104.03 | ↑ +116% |
| Highmark BCBS of PA | CHIP - Managed Care | $5,319.97 | ↑ +125% |
| Highmark BCBS of PA | Commercial | $5,671.12 | ↑ +140% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Pr egd flexible transoral w/placement percutaneous gastrostomy tube at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,869.00 | $729.80 – $2,492.00 |
| UPMC Bedford | Everett | $1,581.00 | $652.52 – $2,371.50 |
| UPMC Cole | Coudersport | $1,693.20 | $326.54 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $2,361.00 | $787.00 – $3,344.75 |
| UPMC East | Monroeville | $3,055.20 | $736.75 – $4,073.60 |
| UPMC Hamot | Erie | $3,124.20 | $729.80 – $2,630.42 |
| UPMC Northwest | Seneca | $1,550.40 | $1,017.75 – $1,953.23 |
| UPMC Hanover | Hanover | $2,361.00 | $1,016.56 – $2,899.50 |