Removal duct glbldr calculi at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,132.80
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.
$1,888.00
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.
$223.46 with Highmark Wholecare (prev Gateway) vs $9,539.00 with Cigna — 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $223.46 | ↓ -80% |
| UPMC Health Plan | Managed Medicaid | $228.74 | ↓ -80% |
| United Healthcare Community Plan for Families | PA Medicaid | $230.49 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $237.53 | ↓ -79% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $239.64 | ↓ -79% |
| Geisinger | Medicaid/CHIP | $256.29 | ↓ -77% |
| Prime Net | Managed Medicare | $258.66 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $299.85 | ↓ -74% |
| Aetna | Medicare | $311.52 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $377.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $377.60 | ↓ -67% |
| Prime Net | Legacy Commercial | $736.32 | ↓ -35% |
| Aetna | ACO | $741.98 | ↓ -35% |
| Prime Net | ACO | $741.98 | ↓ -35% |
| Prime Net | NonGateKeeper | $877.92 | ↓ -23% |
| Aetna | Commercial | $883.58 | ↓ -22% |
| Prime Net | GateKeeper | $883.58 | ↓ -22% |
| Capital Blue Cross | CHIP | $1,032.74 | ↓ -9% |
| Keystone Health Plan | Commercial | $1,032.74 | ↓ -9% |
| Capital Blue Cross | Commercial | $1,032.74 | ↓ -9% |
| UPMC Work Partners | Workers Comp | $1,098.21 | ↓ -3% |
| Wellspan Population Health | PPO | $1,227.20 | ↑ +8% |
| Geisinger | Commercial | $1,236.26 | ↑ +9% |
| UPMC Health Plan | CHIP | $1,321.60 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,321.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,427.33 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,604.80 | ↑ +42% |
| Cigna | Commercial | $9,539.00 | ↑ +742% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Removal duct glbldr calculi at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $1,132.80 | $230.49 – $2,261.63 |
| UPMC Hanover | Hanover | $1,132.80 | $223.46 – $1,098.21 |
| UPMC Lititz | Lititz | $1,132.80 | $143.45 – $1,098.21 |
| UPMC Memorial | York | $1,132.80 | $143.45 – $1,098.21 |
| UPMC Mercy | Pittsburgh | $2,987.40 | $193.54 – $1,200.09 |
| UPMC Passavant-McCandless | Pittsburgh | $5,320.20 | $193.54 – $1,220.23 |
| UPMC Presbyterian | Pittsburgh | $6,650.40 | $193.54 – $1,395.45 |
| UPMC Somerset | Somerset | $1,132.80 | $193.54 – $1,049.40 |