Surgical pathology level 3 gross & microscopic examination at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$116.40
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.
?
What you pay up front if you don't use insurance.
$194.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$8.52 with United Healthcare Community Plan for Families vs $164.90 with Multiplan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $8.52 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $16.53 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $20.99 | ↓ -82% |
| UPMC Health Plan | Managed Medicaid | $21.49 | ↓ -82% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $22.51 | ↓ -81% |
| Geisinger | Medicaid/CHIP | $24.08 | ↓ -79% |
| Prime Net | Managed Medicare | $26.58 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $28.17 | ↓ -76% |
| Capital Blue Cross | Medicare Advantage | $38.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $38.80 | ↓ -67% |
| UPMC Health Plan | CHIP | $48.78 | ↓ -58% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $50.60 | ↓ -57% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $50.60 | ↓ -57% |
| Humana | Medicare | $51.11 | ↓ -56% |
| Aetna | Medicare | $53.31 | ↓ -54% |
| Cigna | Medicare | $53.67 | ↓ -54% |
| Geisinger | Medicare | $53.67 | ↓ -54% |
| United Healthcare | Medicare | $54.69 | ↓ -53% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $55.20 | ↓ -53% |
| Prime Net | Legacy Commercial | $75.66 | ↓ -35% |
| Aetna | ACO | $76.24 | ↓ -35% |
| Prime Net | ACO | $76.24 | ↓ -35% |
| Cigna | Commercial | $77.88 | ↓ -33% |
| Keystone Autism Services | ACAP | $81.78 | ↓ -30% |
| UPMC Work Partners | Workers Comp | $88.20 | ↓ -24% |
| Prime Net | NonGateKeeper | $90.21 | ↓ -23% |
| Prime Net | GateKeeper | $90.79 | ↓ -22% |
| Aetna | Commercial | $90.79 | ↓ -22% |
| Capital Blue Cross | Commercial | $106.12 | ↓ -9% |
| Keystone Health Plan | Commercial | $106.12 | ↓ -9% |
| Capital Blue Cross | CHIP | $106.12 | ↓ -9% |
| Wellspan Population Health | PPO | $126.10 | ↑ +8% |
| Geisinger | Commercial | $127.03 | ↑ +9% |
| UPMC Health Plan | Commercial | $135.80 | ↑ +17% |
| Highmark BCBS of PA | Community Blue PPO | $143.75 | ↑ +23% |
| Prime Net | FH-Medical Rental | $146.66 | ↑ +26% |
| Highmark BCBS of PA | CHIP - Managed Care | $149.83 | ↑ +29% |
| Highmark BCBS of PA | Commercial | $159.72 | ↑ +37% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $164.90 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 3 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $148.80 | $6.50 – $198.40 |
| UPMC Bedford | Everett | $80.40 | $13.60 – $120.60 |
| UPMC Cole | Coudersport | $132.60 | $17.36 – $176.80 |
| UPMC Community Osteopathic | Harrisburg | $116.40 | $8.52 – $164.90 |
| UPMC East | Monroeville | $156.00 | $13.42 – $208.00 |
| UPMC Hamot | Erie | $211.80 | $16.53 – $94.75 |
| UPMC Northwest | Seneca | $74.40 | $13.54 – $85.16 |
| UPMC Hanover | Hanover | $116.40 | $8.52 – $89.12 |