Reconstruct shoulder joint at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
not published by hospital
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.
not published by hospital
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.
$1,016.56 with United Healthcare Community Plan for Families vs $54,977.67 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | — |
| UPMC Work Partners | Workers Comp | $4,497.24 | — |
| UPMC Health Plan | CHIP | $6,970.71 | — |
| Cigna | Commercial | $9,539.00 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $9,675.76 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $17,416.37 | — |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $17,416.37 | — |
| Humana | Medicare | $17,592.29 | — |
| Aetna | Medicare | $18,348.76 | — |
| Geisinger | Medicare | $18,471.90 | — |
| Cigna | Medicare | $18,471.90 | — |
| United Healthcare | Medicare | $18,823.75 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18,999.67 | — |
| Keystone Autism Services | ACAP | $28,147.66 | — |
| Highmark BCBS of PA | Community Blue PPO | $49,480.07 | — |
| Highmark BCBS of PA | CHIP - Managed Care | $51,573.56 | — |
| Highmark BCBS of PA | Commercial | $54,977.67 | — |
| 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
Reconstruct shoulder joint at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $2,881.80 | $1,331.39 – $4,297.36 |
| Uniontown Hospital | Uniontown | $7,222.00 | $205.80 – $35,298.16 |
| UPMC Altoona | Altoona | not published | $2,617.92 – $18,935.33 |
| UPMC Community Osteopathic | Harrisburg | not published | $1,016.56 – $23,763.60 |
| UPMC East | Monroeville | not published | $2,642.84 – $19,285.98 |
| UPMC Hamot | Erie | not published | $2,617.92 – $22,326.53 |
| UPMC Northwest | Seneca | not published | $5,023.39 – $18,935.33 |
| UPMC Hanover | Hanover | not published | $1,016.56 – $28,108.82 |