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Skin Biopsy at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$575.40
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.
$959.00
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.
$40.93 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 | $40.93 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $40.93 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $41.90 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $43.90 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $46.95 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $54.93 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $122.08 | ↓ -79% |
| Prime Net | Managed Medicare | $131.38 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $188.18 | ↓ -67% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $188.18 | ↓ -67% |
| Humana | Medicare | $190.08 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $191.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $191.80 | ↓ -67% |
| Aetna | Medicare | $198.25 | ↓ -66% |
| Cigna | Medicare | $199.58 | ↓ -65% |
| Geisinger | Medicare | $199.58 | ↓ -65% |
| United Healthcare | Medicare | $203.39 | ↓ -65% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $205.29 | ↓ -64% |
| Keystone Autism Services | ACAP | $304.13 | ↓ -47% |
| Prime Net | Legacy Commercial | $374.01 | ↓ -35% |
| Aetna | ACO | $376.89 | ↓ -34% |
| Prime Net | ACO | $376.89 | ↓ -34% |
| Prime Net | NonGateKeeper | $445.94 | ↓ -22% |
| Prime Net | GateKeeper | $448.81 | ↓ -22% |
| Aetna | Commercial | $448.81 | ↓ -22% |
| Capital Blue Cross | CHIP | $524.57 | ↓ -9% |
| Keystone Health Plan | Commercial | $524.57 | ↓ -9% |
| Capital Blue Cross | Commercial | $524.57 | ↓ -9% |
| Highmark BCBS of PA | Community Blue PPO | $534.62 | ↓ -7% |
| Highmark BCBS of PA | CHIP - Managed Care | $557.24 | ↓ -3% |
| Highmark BCBS of PA | Commercial | $594.02 | ↑ +3% |
| UPMC Health Plan | CHIP | $604.18 | ↑ +5% |
| Wellspan Population Health | PPO | $623.35 | ↑ +8% |
| Geisinger | Commercial | $627.95 | ↑ +9% |
| UPMC Health Plan | Commercial | $671.30 | ↑ +17% |
| United Healthcare | Commercial | $705.82 | ↑ +23% |
| Prime Net | FH-Medical Rental | $725.00 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $815.15 | ↑ +42% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +77% |
| Cigna | Commercial | $9,539.00 | ↑ +1558% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Skin Biopsy at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $823.80 | $35.45 – $1,167.05 |
| UPMC Altoona | Altoona | $613.80 | $32.23 – $818.40 |
| UPMC Bedford | Everett | $381.60 | $33.84 – $572.40 |
| UPMC Cole | Coudersport | $357.60 | $31.88 – $2,094.25 |
| UPMC Hanover | Hanover | $575.40 | $40.93 – $1,016.56 |
| UPMC Horizon-Greenville | Greenville | $823.80 | $35.45 – $1,167.05 |
| UPMC Kane | Kane | $98.40 | $35.45 – $131.20 |
| UPMC Lititz | Lititz | $575.40 | $40.93 – $1,016.56 |