Removal cerumen impacted (both sides) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$120.60
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.
$201.00
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.
$27.54 with Prime Net vs $1,016.56 with United Healthcare Community Plan for Families — 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 | $27.54 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $31.25 | ↓ -74% |
| Keystone Health Plan | Medicare Advantage | $40.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $40.20 | ↓ -67% |
| UPMC Health Plan | CHIP | $48.78 | ↓ -60% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $56.25 | ↓ -53% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $56.25 | ↓ -53% |
| Humana | Medicare | $56.82 | ↓ -53% |
| Aetna | Medicare | $59.26 | ↓ -51% |
| Cigna | Medicare | $59.66 | ↓ -51% |
| Geisinger | Medicare | $59.66 | ↓ -51% |
| United Healthcare | Medicare | $60.80 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $61.37 | ↓ -49% |
| UPMC Work Partners | Workers Comp | $76.23 | ↓ -37% |
| Prime Net | Legacy Commercial | $78.39 | ↓ -35% |
| Aetna | ACO | $78.99 | ↓ -35% |
| Prime Net | ACO | $78.99 | ↓ -35% |
| Keystone Autism Services | ACAP | $90.91 | ↓ -25% |
| Prime Net | NonGateKeeper | $93.47 | ↓ -22% |
| Aetna | Commercial | $94.07 | ↓ -22% |
| Prime Net | GateKeeper | $94.07 | ↓ -22% |
| Capital Blue Cross | CHIP | $109.95 | ↓ -9% |
| Keystone Health Plan | Commercial | $109.95 | ↓ -9% |
| Capital Blue Cross | Commercial | $109.95 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $110.55 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $110.55 | ↓ -8% |
| Wellspan Population Health | PPO | $130.65 | ↑ +8% |
| Geisinger | Commercial | $131.61 | ↑ +9% |
| UPMC Health Plan | Commercial | $140.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $151.96 | ↑ +26% |
| Cigna | Commercial | $156.78 | ↑ +30% |
| Highmark BCBS of PA | Community Blue PPO | $159.81 | ↑ +33% |
| Highmark BCBS of PA | CHIP - Managed Care | $166.57 | ↑ +38% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $170.85 | ↑ +42% |
| Highmark BCBS of PA | Commercial | $177.57 | ↑ +47% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +743% |
| 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
Removal cerumen impacted (both sides) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $120.00 | $18.59 – $160.00 |
| UPMC Bedford | Everett | $75.60 | $20.43 – $113.40 |
| UPMC Cole | Coudersport | $153.00 | $9.70 – $98.03 |
| UPMC Community Osteopathic | Harrisburg | $120.60 | $40.20 – $1,016.56 |
| UPMC East | Monroeville | $76.80 | $18.77 – $102.40 |
| UPMC Hamot | Erie | $139.80 | $18.59 – $82.37 |
| UPMC Northwest | Seneca | $79.80 | $23.04 – $68.22 |
| UPMC Hanover | Hanover | $120.60 | $48.78 – $1,016.56 |