Sugars single quant at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$58.80
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.
$98.00
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.
$8.15 with United Healthcare vs $83.30 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 |
|---|---|---|---|
| United Healthcare | Commercial | $8.15 | ↓ -86% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $11.41 | ↓ -81% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $11.41 | ↓ -81% |
| Humana | Medicare | $11.53 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $11.93 | ↓ -80% |
| Aetna | Medicare | $12.03 | ↓ -80% |
| Cigna | Medicare | $12.11 | ↓ -79% |
| Geisinger | Medicare | $12.11 | ↓ -79% |
| United Healthcare | Medicare | $12.34 | ↓ -79% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $12.45 | ↓ -79% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $12.74 | ↓ -78% |
| Prime Net | Managed Medicare | $13.43 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $16.18 | ↓ -72% |
| UPMC Health Plan | Managed Medicaid | $16.56 | ↓ -72% |
| United Healthcare Community Plan for Families | PA Medicaid | $16.69 | ↓ -72% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $17.35 | ↓ -70% |
| Keystone Autism Services | ACAP | $18.45 | ↓ -69% |
| Geisinger | Medicaid/CHIP | $18.56 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $19.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $19.60 | ↓ -67% |
| PA Health & Wellness | PA Medicaid HMO | $21.71 | ↓ -63% |
| Cigna | Commercial | $29.96 | ↓ -49% |
| Highmark BCBS of PA | Community Blue PPO | $32.43 | ↓ -45% |
| Highmark BCBS of PA | CHIP - Managed Care | $33.80 | ↓ -43% |
| Highmark BCBS of PA | Commercial | $36.03 | ↓ -39% |
| Prime Net | Legacy Commercial | $38.22 | ↓ -35% |
| Prime Net | ACO | $38.51 | ↓ -35% |
| Aetna | ACO | $38.51 | ↓ -35% |
| Prime Net | NonGateKeeper | $45.57 | ↓ -23% |
| Aetna | Commercial | $45.86 | ↓ -22% |
| Prime Net | GateKeeper | $45.86 | ↓ -22% |
| Capital Blue Cross | Commercial | $53.61 | ↓ -9% |
| Capital Blue Cross | CHIP | $53.61 | ↓ -9% |
| Keystone Health Plan | Commercial | $53.61 | ↓ -9% |
| Wellspan Population Health | PPO | $63.70 | ↑ +8% |
| Geisinger | Commercial | $64.17 | ↑ +9% |
| UPMC Health Plan | Commercial | $68.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $74.09 | ↑ +26% |
| UPMC Health Plan | CHIP | $78.57 | ↑ +34% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $83.30 | ↑ +42% |
Visitor-reported prices
Comments
Sugars single quant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $58.80 | $11.41 – $83.30 |
| UPMC East | Monroeville | $198.60 | $11.39 – $264.80 |
| UPMC Hamot | Erie | $111.60 | $11.39 – $30.58 |
| UPMC Northwest | Seneca | $104.40 | $10.46 – $14.65 |
| UPMC Hanover | Hanover | $58.80 | $8.15 – $18.45 |
| UPMC Lititz | Lititz | $58.80 | $8.15 – $18.45 |
| UPMC Magee | Pittsburgh | $114.60 | $10.79 – $30.87 |
| UPMC McKeesport | Mckeesport | $106.20 | $10.69 – $30.87 |