Prq card revasc mi 1 vsl drug-eluting at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$15,411.00
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.
$25,685.00
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.
$3,518.84 with Prime Net vs $21,832.25 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $3,518.84 | ↓ -77% |
| Aetna | Medicare | $4,238.02 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $5,137.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $5,137.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $10,017.15 | ↓ -35% |
| Prime Net | ACO | $10,094.20 | ↓ -35% |
| Aetna | ACO | $10,094.20 | ↓ -35% |
| Prime Net | NonGateKeeper | $11,943.52 | ↓ -23% |
| Aetna | Commercial | $12,020.58 | ↓ -22% |
| Prime Net | GateKeeper | $12,020.58 | ↓ -22% |
| Keystone Health Plan | Commercial | $14,049.69 | ↓ -9% |
| Capital Blue Cross | Commercial | $14,049.69 | ↓ -9% |
| Capital Blue Cross | CHIP | $14,049.69 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $14,126.75 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $14,126.75 | ↓ -8% |
| Wellspan Population Health | PPO | $16,695.25 | ↑ +8% |
| Geisinger | Commercial | $16,818.54 | ↑ +9% |
| Cigna | Commercial | $17,298.00 | ↑ +12% |
| UPMC Health Plan | Commercial | $17,979.50 | ↑ +17% |
| UPMC Health Plan | CHIP | $17,979.50 | ↑ +17% |
| Prime Net | FH-Medical Rental | $19,417.86 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $21,832.25 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Prq card revasc mi 1 vsl drug-eluting at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $10,182.60 | $2,142.86 – $13,576.80 |
| UPMC Community Osteopathic | Harrisburg | $15,411.00 | $5,137.00 – $21,832.25 |
| UPMC Hamot | Erie | $22,600.20 | $2,142.86 – $2,142.86 |
| UPMC Northwest | Seneca | $14,003.40 | $5,561.55 – $5,561.55 |
| UPMC Jameson | New Castle | $11,088.60 | $688.00 – $2,180.67 |
| UPMC Lititz | Lititz | $15,411.00 | $688.00 – $688.00 |
| UPMC McKeesport | Mckeesport | $12,302.40 | $756.80 – $2,163.27 |
| UPMC Memorial | York | $15,411.00 | $688.00 – $1,746.52 |