Prostate biopsy, any mthd at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$643.20
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.
$1,072.00
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.
$146.86 with Prime Net vs $1,075.41 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $146.86 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $189.27 | ↓ -71% |
| Keystone Health Plan | Medicare Advantage | $214.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $214.40 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $259.00 | ↓ -60% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $340.68 | ↓ -47% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $340.68 | ↓ -47% |
| Humana | Medicare | $344.12 | ↓ -46% |
| Aetna | Medicare | $358.92 | ↓ -44% |
| Geisinger | Medicare | $361.33 | ↓ -44% |
| Cigna | Medicare | $361.33 | ↓ -44% |
| United Healthcare | Medicare | $368.21 | ↓ -43% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $371.65 | ↓ -42% |
| Prime Net | Legacy Commercial | $418.08 | ↓ -35% |
| Prime Net | ACO | $421.30 | ↓ -34% |
| Aetna | ACO | $421.30 | ↓ -34% |
| UPMC Health Plan | CHIP | $465.14 | ↓ -28% |
| Prime Net | NonGateKeeper | $498.48 | ↓ -23% |
| Aetna | Commercial | $501.70 | ↓ -22% |
| Prime Net | GateKeeper | $501.70 | ↓ -22% |
| Keystone Autism Services | ACAP | $550.59 | ↓ -14% |
| Capital Blue Cross | Commercial | $586.38 | ↓ -9% |
| Keystone Health Plan | Commercial | $586.38 | ↓ -9% |
| Capital Blue Cross | CHIP | $586.38 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $589.60 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $589.60 | ↓ -8% |
| Wellspan Population Health | PPO | $696.80 | ↑ +8% |
| Geisinger | Commercial | $701.95 | ↑ +9% |
| UPMC Health Plan | Commercial | $750.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $810.43 | ↑ +26% |
| Cigna | Commercial | $836.16 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $911.20 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $967.87 | ↑ +50% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,008.82 | ↑ +57% |
| Highmark BCBS of PA | Commercial | $1,075.41 | ↑ +67% |
| UPMC Work Partners | Workers Comp | 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
Prostate biopsy, any mthd at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $287.40 | $239.50 – $774.58 |
| UPMC Bedford | Everett | $308.40 | $123.74 – $462.60 |
| UPMC Cole | Coudersport | $1,301.40 | $53.00 – $1,735.20 |
| UPMC Community Osteopathic | Harrisburg | $643.20 | $214.40 – $911.20 |
| UPMC East | Monroeville | $308.40 | $127.95 – $781.96 |
| UPMC Hamot | Erie | $334.20 | $157.05 – $774.58 |
| UPMC Northwest | Seneca | $308.40 | $129.14 – $370.39 |
| UPMC Hanover | Hanover | $643.20 | $259.00 – $549.82 |