Thrombectomy/inf pq dialysis circuit w/pta at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$24,300.00
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.
$40,500.00
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.
$446.44 with Highmark Wholecare (prev Gateway) vs $34,425.00 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 | $446.44 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $446.44 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $456.99 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $478.78 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $512.04 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $599.08 | ↓ -98% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $2,993.99 | ↓ -88% |
| Premier Comp Solutions | Worker's Comp | $2,993.99 | ↓ -88% |
| Prime Net | Managed Medicare | $5,548.50 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $8,100.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $8,100.00 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $10,740.13 | ↓ -56% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $10,740.13 | ↓ -56% |
| Humana | Medicare | $10,848.62 | ↓ -55% |
| Aetna | Medicare | $11,315.11 | ↓ -53% |
| Geisinger | Medicare | $11,391.05 | ↓ -53% |
| Cigna | Medicare | $11,391.05 | ↓ -53% |
| United Healthcare | Medicare | $11,608.02 | ↓ -52% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11,716.51 | ↓ -52% |
| Prime Net | Legacy Commercial | $15,795.00 | ↓ -35% |
| Aetna | ACO | $15,916.50 | ↓ -35% |
| Prime Net | ACO | $15,916.50 | ↓ -35% |
| Keystone Autism Services | ACAP | $17,357.79 | ↓ -29% |
| Prime Net | NonGateKeeper | $18,832.50 | ↓ -23% |
| Aetna | Commercial | $18,954.00 | ↓ -22% |
| Prime Net | GateKeeper | $18,954.00 | ↓ -22% |
| Capital Blue Cross | CHIP | $22,153.50 | ↓ -9% |
| Keystone Health Plan | Commercial | $22,153.50 | ↓ -9% |
| Capital Blue Cross | Commercial | $22,153.50 | ↓ -9% |
| Wellspan Population Health | PPO | $26,325.00 | ↑ +8% |
| Geisinger | Commercial | $26,519.40 | ↑ +9% |
| UPMC Health Plan | Commercial | $28,350.00 | ↑ +17% |
| UPMC Health Plan | CHIP | $28,350.00 | ↑ +17% |
| United Healthcare | Commercial | $29,808.00 | ↑ +23% |
| Highmark BCBS of PA | Community Blue PPO | $30,512.83 | ↑ +26% |
| Prime Net | FH-Medical Rental | $30,618.00 | ↑ +26% |
| Cigna | Commercial | $31,590.00 | ↑ +30% |
| Highmark BCBS of PA | CHIP - Managed Care | $31,803.81 | ↑ +31% |
| Highmark BCBS of PA | Commercial | $33,903.02 | ↑ +40% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $34,425.00 | ↑ +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 w/pta at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $24,300.00 | $446.44 – $34,425.00 |
| UPMC East | Monroeville | $7,662.00 | $386.68 – $11,352.46 |
| UPMC Hamot | Erie | $5,134.20 | $386.68 – $15,725.10 |
| UPMC Hanover | Hanover | $24,300.00 | $446.44 – $17,333.84 |
| UPMC Lititz | Lititz | $24,300.00 | $446.44 – $17,427.46 |
| UPMC Magee | Pittsburgh | $7,348.80 | $386.68 – $11,676.82 |
| UPMC McKeesport | Mckeesport | $9,645.00 | $386.68 – $11,893.06 |
| UPMC Memorial | York | $24,300.00 | $446.44 – $17,399.15 |