Special teletx port plan at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$939.60
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.
$1,566.00
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.
$41.27 with United Healthcare Community Plan for Families vs $26,132.00 with United Healthcare — 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 | $41.27 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $65.79 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $65.79 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $67.34 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $70.55 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $75.45 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $88.28 | ↓ -91% |
| Prime Net | Managed Medicare | $214.54 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $313.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $313.20 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $346.69 | ↓ -63% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $346.69 | ↓ -63% |
| Humana | Medicare | $350.19 | ↓ -63% |
| Aetna | Medicare | $365.25 | ↓ -61% |
| Cigna | Medicare | $367.70 | ↓ -61% |
| Geisinger | Medicare | $367.70 | ↓ -61% |
| United Healthcare | Medicare | $374.70 | ↓ -60% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $378.21 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $479.30 | ↓ -49% |
| Keystone Autism Services | ACAP | $560.30 | ↓ -40% |
| Prime Net | Legacy Commercial | $610.74 | ↓ -35% |
| Aetna | ACO | $615.44 | ↓ -34% |
| Prime Net | ACO | $615.44 | ↓ -34% |
| Prime Net | NonGateKeeper | $728.19 | ↓ -23% |
| Aetna | Commercial | $732.89 | ↓ -22% |
| Prime Net | GateKeeper | $732.89 | ↓ -22% |
| UPMC Health Plan | CHIP | $736.12 | ↓ -22% |
| Capital Blue Cross | CHIP | $856.60 | ↓ -9% |
| Capital Blue Cross | Commercial | $856.60 | ↓ -9% |
| Keystone Health Plan | Commercial | $856.60 | ↓ -9% |
| Highmark BCBS of PA | Community Blue PPO | $984.94 | ↑ +5% |
| Wellspan Population Health | PPO | $1,017.90 | ↑ +8% |
| Geisinger | Commercial | $1,025.42 | ↑ +9% |
| Highmark BCBS of PA | CHIP - Managed Care | $1,026.62 | ↑ +9% |
| Highmark BCBS of PA | Commercial | $1,094.38 | ↑ +16% |
| UPMC Health Plan | Commercial | $1,096.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,183.90 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,331.10 | ↑ +42% |
| Cigna | Commercial | $1,761.44 | ↑ +87% |
| United Healthcare | Commercial | $26,132.00 | ↑ +2681% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Special teletx port plan at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,248.60 | $31.50 – $1,664.80 |
| UPMC Community Osteopathic | Harrisburg | $939.60 | $41.27 – $1,331.10 |
| UPMC Northwest | Seneca | $1,515.00 | $56.98 – $464.85 |
| UPMC Lititz | Lititz | $939.60 | $41.27 – $562.56 |
| UPMC Magee | Pittsburgh | $1,035.60 | $56.98 – $499.85 |
| UPMC Memorial | York | $939.60 | $41.27 – $561.63 |
| UPMC Passavant-McCandless | Pittsburgh | $1,286.40 | $56.98 – $581.22 |
| UPMC Presbyterian | Pittsburgh | $1,078.80 | $37.80 – $590.88 |