Puncture spinal lumbar diagnostic at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$2,020.80
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.
$3,368.00
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.
$53.34 with AmeriHealth Caritas vs $2,862.80 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $53.34 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $53.34 | ↓ -97% |
| UPMC Health Plan | Managed Medicaid | $54.60 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $57.20 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $61.18 | ↓ -97% |
| PA Health & Wellness | PA Medicaid HMO | $71.58 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $168.12 | ↓ -92% |
| Prime Net | Managed Medicare | $461.42 | ↓ -77% |
| United Healthcare Community Plan for Families | PA Medicaid | $468.98 | ↓ -77% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $655.86 | ↓ -68% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $655.86 | ↓ -68% |
| Humana | Medicare | $662.48 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $673.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $673.60 | ↓ -67% |
| Aetna | Medicare | $690.97 | ↓ -66% |
| Geisinger | Medicare | $695.60 | ↓ -66% |
| Cigna | Medicare | $695.60 | ↓ -66% |
| United Healthcare | Medicare | $708.85 | ↓ -65% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $715.48 | ↓ -65% |
| Keystone Autism Services | ACAP | $1,059.97 | ↓ -48% |
| Prime Net | Legacy Commercial | $1,313.52 | ↓ -35% |
| Prime Net | ACO | $1,323.62 | ↓ -35% |
| Aetna | ACO | $1,323.62 | ↓ -35% |
| Prime Net | NonGateKeeper | $1,566.12 | ↓ -23% |
| Prime Net | GateKeeper | $1,576.22 | ↓ -22% |
| Aetna | Commercial | $1,576.22 | ↓ -22% |
| UPMC Health Plan | CHIP | $1,712.70 | ↓ -15% |
| Capital Blue Cross | CHIP | $1,842.30 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,842.30 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,842.30 | ↓ -9% |
| Highmark BCBS of PA | Community Blue PPO | $1,863.29 | ↓ -8% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,942.13 | ↓ -4% |
| Highmark BCBS of PA | Commercial | $2,070.32 | ↑ +2% |
| Wellspan Population Health | PPO | $2,189.20 | ↑ +8% |
| Geisinger | Commercial | $2,205.37 | ↑ +9% |
| UPMC Health Plan | Commercial | $2,357.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $2,546.21 | ↑ +26% |
| Cigna | Commercial | $2,627.04 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,862.80 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Puncture spinal lumbar diagnostic at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,192.20 | $42.00 – $1,589.60 |
| UPMC Bedford | Everett | $1,214.40 | $44.10 – $1,821.60 |
| UPMC Cole | Coudersport | $1,266.00 | $33.54 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $2,040.00 | $53.34 – $2,862.80 |
| UPMC East | Monroeville | $2,281.20 | $46.20 – $3,041.60 |
| UPMC Hamot | Erie | $2,310.60 | $46.20 – $960.26 |
| UPMC Northwest | Seneca | $1,156.80 | $46.20 – $693.24 |
| UPMC Hanover | Hanover | $2,020.80 | $53.34 – $1,058.50 |