Tc-99m sestamibi p study dose at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$201.00
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.
$335.00
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.
$45.90 with Prime Net vs $668.53 with UPMC Health Plan — 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $45.90 | ↓ -77% |
| Aetna | Medicare | $55.27 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $67.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $67.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $130.65 | ↓ -35% |
| Aetna | ACO | $131.66 | ↓ -34% |
| Prime Net | ACO | $131.66 | ↓ -34% |
| Cigna | Commercial | $133.82 | ↓ -33% |
| Prime Net | NonGateKeeper | $155.78 | ↓ -22% |
| Aetna | Commercial | $156.78 | ↓ -22% |
| Prime Net | GateKeeper | $156.78 | ↓ -22% |
| Capital Blue Cross | CHIP | $183.25 | ↓ -9% |
| Capital Blue Cross | Commercial | $183.25 | ↓ -9% |
| Keystone Health Plan | Commercial | $183.25 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $184.25 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $184.25 | ↓ -8% |
| United Healthcare | Commercial | $206.36 | ↑ +3% |
| Wellspan Population Health | PPO | $217.75 | ↑ +8% |
| Geisinger | Commercial | $219.36 | ↑ +9% |
| UPMC Health Plan | Commercial | $234.50 | ↑ +17% |
| Prime Net | FH-Medical Rental | $253.26 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $284.75 | ↑ +42% |
| UPMC Health Plan | CHIP | $668.53 | ↑ +233% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Tc-99m sestamibi p study dose at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $446.40 | $226.22 – $1,351.74 |
| UPMC Bedford | Everett | $652.80 | $272.00 – $979.20 |
| UPMC Cole | Coudersport | $528.00 | $243.94 – $704.00 |
| UPMC Community Osteopathic | Harrisburg | $610.80 | $67.00 – $668.53 |
| UPMC East | Monroeville | $1,290.00 | $228.37 – $1,720.00 |
| UPMC Hamot | Erie | $498.60 | $51.00 – $1,226.71 |
| UPMC Northwest | Seneca | $725.40 | $587.12 – $808.98 |
| UPMC Hanover | Hanover | $201.00 | $133.82 – $668.53 |