Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$100.20
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.
$167.00
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.
$17.87 with Highmark BCBS of PA vs $141.95 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $17.87 | ↓ -82% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $17.87 | ↓ -82% |
| Humana | Medicare | $18.05 | ↓ -82% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $18.22 | ↓ -82% |
| Aetna | Medicare | $18.83 | ↓ -81% |
| Cigna | Medicare | $18.95 | ↓ -81% |
| Geisinger | Medicare | $18.95 | ↓ -81% |
| United Healthcare | Medicare | $19.31 | ↓ -81% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $19.49 | ↓ -81% |
| Prime Net | Managed Medicare | $22.88 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $23.14 | ↓ -77% |
| UPMC Health Plan | Managed Medicaid | $23.69 | ↓ -76% |
| United Healthcare Community Plan for Families | PA Medicaid | $23.87 | ↓ -76% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $24.82 | ↓ -75% |
| Geisinger | Medicaid/CHIP | $26.54 | ↓ -74% |
| Keystone Autism Services | ACAP | $28.88 | ↓ -71% |
| PA Health & Wellness | PA Medicaid HMO | $31.05 | ↓ -69% |
| Keystone Health Plan | Medicare Advantage | $33.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $33.40 | ↓ -67% |
| Highmark BCBS of PA | Community Blue PPO | $50.77 | ↓ -49% |
| Highmark BCBS of PA | CHIP - Managed Care | $52.92 | ↓ -47% |
| Highmark BCBS of PA | Commercial | $56.41 | ↓ -44% |
| UPMC Health Plan | CHIP | $60.82 | ↓ -39% |
| Prime Net | Legacy Commercial | $65.13 | ↓ -35% |
| Aetna | ACO | $65.63 | ↓ -35% |
| Prime Net | ACO | $65.63 | ↓ -35% |
| Prime Net | NonGateKeeper | $77.66 | ↓ -22% |
| Prime Net | GateKeeper | $78.16 | ↓ -22% |
| Aetna | Commercial | $78.16 | ↓ -22% |
| Keystone Health Plan | Commercial | $91.35 | ↓ -9% |
| Capital Blue Cross | CHIP | $91.35 | ↓ -9% |
| Capital Blue Cross | Commercial | $91.35 | ↓ -9% |
| Wellspan Population Health | PPO | $108.55 | ↑ +8% |
| Geisinger | Commercial | $109.35 | ↑ +9% |
| UPMC Health Plan | Commercial | $116.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $126.25 | ↑ +26% |
| Cigna | Commercial | $130.26 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $141.95 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $100.20 | $17.87 – $141.95 |
| UPMC Hanover | Hanover | $100.20 | $17.87 – $28.88 |
| UPMC Lititz | Lititz | $100.20 | $17.87 – $28.88 |
| UPMC Memorial | York | $100.20 | $18.22 – $115.05 |
| UPMC Muncy | Muncy | $241.20 | $20.04 – $31.05 |
| UPMC Somerset | Somerset | $100.20 | $17.87 – $25.32 |
| UPMC Wellsboro | Wellsboro | $292.00 | $18.22 – $31.05 |