Pralatrexate injection at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$4,072.20
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.
$6,787.00
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.
$388.70 with Highmark BCBS of PA vs $4,233.85 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 |
|---|---|---|---|
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $388.70 | ↓ -90% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $388.70 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $392.63 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $392.63 | ↓ -90% |
| PA Health & Wellness | PA Medicaid HMO | $392.63 | ↓ -90% |
| Humana | Medicare | $392.63 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $400.48 | ↓ -90% |
| Cigna | Commercial | $407.69 | ↓ -90% |
| Aetna | Medicare | $409.51 | ↓ -90% |
| Geisinger | Medicare | $412.26 | ↓ -90% |
| Cigna | Medicare | $412.26 | ↓ -90% |
| United Healthcare | Medicare | $420.11 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $424.04 | ↓ -90% |
| UPMC Health Plan | Managed Medicaid | $431.89 | ↓ -89% |
| UPMC Health Plan | CHIP | $482.93 | ↓ -88% |
| Keystone Autism Services | ACAP | $628.21 | ↓ -85% |
| Prime Net | Managed Medicare | $682.40 | ↓ -83% |
| Keystone Health Plan | Medicare Advantage | $996.20 | ↓ -76% |
| Capital Blue Cross | Medicare Advantage | $996.20 | ↓ -76% |
| Highmark BCBS of PA | Community Blue PPO | $1,104.31 | ↓ -73% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,151.03 | ↓ -72% |
| Highmark BCBS of PA | Commercial | $1,227.01 | ↓ -70% |
| Keystone Health Plan | Commercial | $1,598.90 | ↓ -61% |
| Capital Blue Cross | Commercial | $1,598.90 | ↓ -61% |
| Capital Blue Cross | CHIP | $1,598.90 | ↓ -61% |
| Prime Net | Legacy Commercial | $1,942.59 | ↓ -52% |
| Aetna | ACO | $1,957.53 | ↓ -52% |
| Prime Net | ACO | $1,957.53 | ↓ -52% |
| UPMC Work Partners | Workers Comp | $2,028.26 | ↓ -50% |
| United Healthcare | Commercial | $2,030.48 | ↓ -50% |
| Prime Net | NonGateKeeper | $2,316.16 | ↓ -43% |
| Aetna | Commercial | $2,331.11 | ↓ -43% |
| Prime Net | GateKeeper | $2,331.11 | ↓ -43% |
| Wellspan Population Health | PPO | $3,237.65 | ↓ -20% |
| Geisinger | Commercial | $3,261.56 | ↓ -20% |
| UPMC Health Plan | Commercial | $3,486.70 | ↓ -14% |
| Prime Net | FH-Medical Rental | $3,765.64 | ↓ -8% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,233.85 | ↑ +4% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Pralatrexate injection at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $4,072.20 | $388.70 – $4,233.85 |
| UPMC East | Monroeville | $788.00 | $117.81 – $788.00 |
| UPMC Hanover | Hanover | $4,072.20 | $388.70 – $628.21 |
| UPMC Lititz | Lititz | $4,072.20 | $388.70 – $628.21 |
| UPMC McKeesport | Mckeesport | $786.00 | $247.91 – $431.89 |
| UPMC Memorial | York | $4,072.20 | $269.87 – $628.21 |
| UPMC Presbyterian | Pittsburgh | $33,372.00 | $247.91 – $431.89 |
| UPMC Somerset | Somerset | $4,072.20 | $327.76 – $392.63 |