Pr incision & drainage abscess vulva/perineal at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$831.60
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.
$1,386.00
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.
$119.14 with AmeriHealth Caritas vs $2,316.05 with UPMC Health Plan — 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 | $119.14 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $119.14 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $121.95 | ↓ -85% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $127.77 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $136.64 | ↓ -84% |
| PA Health & Wellness | PA Medicaid HMO | $159.87 | ↓ -81% |
| Prime Net | Managed Medicare | $189.88 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $277.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $277.20 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $288.08 | ↓ -65% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $288.08 | ↓ -65% |
| UPMC Work Partners | Workers Comp | $288.85 | ↓ -65% |
| Humana | Medicare | $290.99 | ↓ -65% |
| Aetna | Medicare | $303.50 | ↓ -64% |
| Cigna | Medicare | $305.54 | ↓ -63% |
| Geisinger | Medicare | $305.54 | ↓ -63% |
| United Healthcare | Medicare | $311.36 | ↓ -63% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $314.27 | ↓ -62% |
| Keystone Autism Services | ACAP | $465.58 | ↓ -44% |
| Prime Net | Legacy Commercial | $540.54 | ↓ -35% |
| Prime Net | ACO | $544.70 | ↓ -34% |
| Aetna | ACO | $544.70 | ↓ -34% |
| Prime Net | NonGateKeeper | $644.49 | ↓ -23% |
| Prime Net | GateKeeper | $648.65 | ↓ -22% |
| Aetna | Commercial | $648.65 | ↓ -22% |
| Capital Blue Cross | CHIP | $758.14 | ↓ -9% |
| Keystone Health Plan | Commercial | $758.14 | ↓ -9% |
| Capital Blue Cross | Commercial | $758.14 | ↓ -9% |
| Highmark BCBS of PA | Community Blue PPO | $818.44 | ↓ -2% |
| Highmark BCBS of PA | CHIP - Managed Care | $853.07 | ↑ +3% |
| Wellspan Population Health | PPO | $900.90 | ↑ +8% |
| Geisinger | Commercial | $907.55 | ↑ +9% |
| Highmark BCBS of PA | Commercial | $909.37 | ↑ +9% |
| UPMC Health Plan | Commercial | $970.20 | ↑ +17% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +22% |
| Prime Net | FH-Medical Rental | $1,047.82 | ↑ +26% |
| Cigna | Commercial | $1,081.08 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,178.10 | ↑ +42% |
| UPMC Health Plan | CHIP | $2,316.05 | ↑ +179% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Pr incision & drainage abscess vulva/perineal at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,184.80 | $93.81 – $4,246.40 |
| UPMC Bedford | Everett | $4,303.80 | $98.50 – $6,455.70 |
| UPMC Cole | Coudersport | $1,693.20 | $91.75 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $831.60 | $119.14 – $2,316.05 |
| UPMC East | Monroeville | $3,055.20 | $103.19 – $4,073.60 |
| UPMC Hamot | Erie | $3,124.20 | $103.19 – $729.80 |
| UPMC Northwest | Seneca | $2,183.40 | $103.19 – $304.51 |
| UPMC Hanover | Hanover | $831.60 | $119.14 – $1,016.56 |