Pretreat rbc w chem/drugs reference at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$48.00
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.
?
What you pay up front if you don't use insurance.
$80.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$10.96 with Prime Net vs $177.57 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $10.96 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $16.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $16.00 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $27.14 | ↓ -43% |
| Prime Net | Legacy Commercial | $31.20 | ↓ -35% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $31.25 | ↓ -35% |
| Aetna | ACO | $31.44 | ↓ -35% |
| Prime Net | ACO | $31.44 | ↓ -35% |
| Prime Net | NonGateKeeper | $37.20 | ↓ -23% |
| Prime Net | GateKeeper | $37.44 | ↓ -22% |
| Aetna | Commercial | $37.44 | ↓ -22% |
| Capital Blue Cross | Commercial | $43.76 | ↓ -9% |
| Keystone Health Plan | Commercial | $43.76 | ↓ -9% |
| Capital Blue Cross | CHIP | $43.76 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $44.00 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $44.00 | ↓ -8% |
| Wellspan Population Health | PPO | $52.00 | ↑ +8% |
| Geisinger | Commercial | $52.38 | ↑ +9% |
| UPMC Health Plan | Commercial | $56.00 | ↑ +17% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $56.25 | ↑ +17% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $56.25 | ↑ +17% |
| Humana | Medicare | $56.82 | ↑ +18% |
| Aetna | Medicare | $59.26 | ↑ +23% |
| Cigna | Medicare | $59.66 | ↑ +24% |
| Geisinger | Medicare | $59.66 | ↑ +24% |
| Prime Net | FH-Medical Rental | $60.48 | ↑ +26% |
| United Healthcare | Medicare | $60.80 | ↑ +27% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $61.37 | ↑ +28% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $68.00 | ↑ +42% |
| Cigna | Commercial | $78.80 | ↑ +64% |
| Keystone Autism Services | ACAP | $90.91 | ↑ +89% |
| UPMC Health Plan | CHIP | $131.88 | ↑ +175% |
| United Healthcare | Commercial | $155.02 | ↑ +223% |
| Highmark BCBS of PA | Community Blue PPO | $159.81 | ↑ +233% |
| Highmark BCBS of PA | CHIP - Managed Care | $166.57 | ↑ +247% |
| Highmark BCBS of PA | Commercial | $177.57 | ↑ +270% |
| Tricare | East Region | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Pretreat rbc w chem/drugs reference at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $359.40 | $48.24 – $479.20 |
| UPMC Bedford | Everett | $125.40 | $20.43 – $188.10 |
| UPMC Community Osteopathic | Harrisburg | $48.00 | $16.00 – $131.88 |
| UPMC East | Monroeville | $371.40 | $36.28 – $495.20 |
| UPMC Northwest | Seneca | $298.80 | $36.62 – $61.16 |
| UPMC Hanover | Hanover | $48.00 | $27.14 – $131.88 |
| UPMC Horizon-Greenville | Greenville | $165.00 | $36.73 – $78.00 |
| UPMC Jameson | New Castle | $54.60 | $2.20 – $61.16 |