Thrombectomy/inf pq dialysis circuit at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$12,394.80
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.
$20,658.00
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.
$355.68 with Highmark Wholecare (prev Gateway) vs $17,559.30 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $355.68 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $355.68 | ↓ -97% |
| UPMC Health Plan | Managed Medicaid | $364.08 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $381.44 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $407.94 | ↓ -97% |
| PA Health & Wellness | PA Medicaid HMO | $477.28 | ↓ -96% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $2,340.14 | ↓ -81% |
| Premier Comp Solutions | Worker's Comp | $2,340.14 | ↓ -81% |
| Prime Net | Managed Medicare | $2,830.15 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $4,131.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $4,131.60 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $5,399.65 | ↓ -56% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $5,399.65 | ↓ -56% |
| Humana | Medicare | $5,454.19 | ↓ -56% |
| Aetna | Medicare | $5,688.72 | ↓ -54% |
| Geisinger | Medicare | $5,726.90 | ↓ -54% |
| Cigna | Medicare | $5,726.90 | ↓ -54% |
| United Healthcare | Medicare | $5,835.98 | ↓ -53% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $5,890.53 | ↓ -52% |
| Prime Net | Legacy Commercial | $8,056.62 | ↓ -35% |
| Aetna | ACO | $8,118.59 | ↓ -35% |
| Prime Net | ACO | $8,118.59 | ↓ -35% |
| Keystone Autism Services | ACAP | $8,726.70 | ↓ -30% |
| Prime Net | NonGateKeeper | $9,605.97 | ↓ -23% |
| Aetna | Commercial | $9,667.94 | ↓ -22% |
| Prime Net | GateKeeper | $9,667.94 | ↓ -22% |
| Capital Blue Cross | CHIP | $11,299.93 | ↓ -9% |
| Keystone Health Plan | Commercial | $11,299.93 | ↓ -9% |
| Capital Blue Cross | Commercial | $11,299.93 | ↓ -9% |
| Wellspan Population Health | PPO | $13,427.70 | ↑ +8% |
| Geisinger | Commercial | $13,526.86 | ↑ +9% |
| UPMC Health Plan | Commercial | $14,460.60 | ↑ +17% |
| UPMC Health Plan | CHIP | $14,460.60 | ↑ +17% |
| United Healthcare | Commercial | $15,204.29 | ↑ +23% |
| Highmark BCBS of PA | Community Blue PPO | $15,340.45 | ↑ +24% |
| Prime Net | FH-Medical Rental | $15,617.45 | ↑ +26% |
| Highmark BCBS of PA | CHIP - Managed Care | $15,989.50 | ↑ +29% |
| Cigna | Commercial | $16,113.24 | ↑ +30% |
| Highmark BCBS of PA | Commercial | $17,044.89 | ↑ +38% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $17,559.30 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Thrombectomy/inf pq dialysis circuit at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $12,394.80 | $355.68 – $17,559.30 |
| UPMC East | Monroeville | $4,951.20 | $308.07 – $6,601.60 |
| UPMC Hamot | Erie | $2,865.60 | $308.07 – $7,905.86 |
| UPMC Hanover | Hanover | $12,394.80 | $355.68 – $8,714.66 |
| UPMC Lititz | Lititz | $12,394.80 | $355.68 – $8,761.73 |
| UPMC Magee | Pittsburgh | $5,254.20 | $308.07 – $5,870.58 |
| UPMC McKeesport | Mckeesport | $5,719.80 | $308.07 – $5,979.29 |
| UPMC Memorial | York | $12,394.80 | $355.68 – $8,747.50 |