Pt evaluation moderate complexity patient/family at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$303.60
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.
$506.00
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.
$33.18 with United Healthcare Community Plan for Families vs $430.10 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $33.18 | ↓ -89% |
| Prime Net | Managed Medicare | $69.32 | ↓ -77% |
| Aetna | Medicare | $83.49 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $101.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $101.20 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $133.59 | ↓ -56% |
| United Healthcare | Commercial | $148.00 | ↓ -51% |
| Prime Net | Legacy Commercial | $197.34 | ↓ -35% |
| Aetna | ACO | $198.86 | ↓ -34% |
| Prime Net | ACO | $198.86 | ↓ -34% |
| UPMC Health Plan | CHIP | $211.51 | ↓ -30% |
| Prime Net | NonGateKeeper | $235.29 | ↓ -23% |
| Prime Net | GateKeeper | $236.81 | ↓ -22% |
| Aetna | Commercial | $236.81 | ↓ -22% |
| Capital Blue Cross | CHIP | $276.78 | ↓ -9% |
| Keystone Health Plan | Commercial | $276.78 | ↓ -9% |
| Capital Blue Cross | Commercial | $276.78 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $278.30 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $278.30 | ↓ -8% |
| Wellspan Population Health | PPO | $328.90 | ↑ +8% |
| Geisinger | Commercial | $331.33 | ↑ +9% |
| UPMC Health Plan | Commercial | $354.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $382.54 | ↑ +26% |
| Cigna | Commercial | $387.00 | ↑ +27% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $430.10 | ↑ +42% |
Visitor-reported prices
Comments
Pt evaluation moderate complexity patient/family at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $216.00 | $51.56 – $288.00 |
| UPMC Bedford | Everett | $299.40 | $124.75 – $449.10 |
| UPMC Cole | Coudersport | $281.40 | $84.11 – $375.20 |
| UPMC Community Osteopathic | Harrisburg | $303.60 | $33.18 – $430.10 |
| UPMC East | Monroeville | $411.60 | $52.05 – $548.80 |
| UPMC Hamot | Erie | $304.80 | $51.56 – $177.27 |
| UPMC Northwest | Seneca | $320.40 | $127.65 – $255.95 |
| UPMC Hanover | Hanover | $303.60 | $33.18 – $211.51 |