Tib/per revasc w/ather add-on 37233 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$14,982.00
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.
$24,970.00
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.
$367.02 with United Healthcare Community Plan for Families vs $21,224.50 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 Community Plan for Families | PA Medicaid | $367.02 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $2,303.65 | ↓ -85% |
| Prime Net | Managed Medicare | $3,420.89 | ↓ -77% |
| Aetna | Medicare | $4,120.05 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $4,994.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $4,994.00 | ↓ -67% |
| Prime Net | Legacy Commercial | $9,738.30 | ↓ -35% |
| Prime Net | ACO | $9,813.21 | ↓ -35% |
| Aetna | ACO | $9,813.21 | ↓ -35% |
| Prime Net | NonGateKeeper | $11,611.05 | ↓ -23% |
| Prime Net | GateKeeper | $11,685.96 | ↓ -22% |
| Aetna | Commercial | $11,685.96 | ↓ -22% |
| UPMC Health Plan | CHIP | $12,611.03 | ↓ -16% |
| Keystone Health Plan | Commercial | $13,658.59 | ↓ -9% |
| Capital Blue Cross | Commercial | $13,658.59 | ↓ -9% |
| Capital Blue Cross | CHIP | $13,658.59 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $13,733.50 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $13,733.50 | ↓ -8% |
| Wellspan Population Health | PPO | $16,230.50 | ↑ +8% |
| Geisinger | Commercial | $16,350.36 | ↑ +9% |
| Cigna | Commercial | $17,298.00 | ↑ +15% |
| UPMC Health Plan | Commercial | $17,479.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $18,877.32 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $21,224.50 | ↑ +42% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Tib/per revasc w/ather add-on 37233 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $14,982.00 | $367.02 – $21,224.50 |
| UPMC Hamot | Erie | $11,931.00 | $2,201.26 – $15,657.05 |
| UPMC Hanover | Hanover | $14,982.00 | $367.02 – $12,611.03 |
| UPMC Jameson | New Castle | $11,790.00 | $322.20 – $12,611.03 |
| UPMC Lititz | Lititz | $14,982.00 | $367.02 – $12,611.03 |
| UPMC Memorial | York | $14,982.00 | $367.02 – $12,611.03 |
| UPMC Somerset | Somerset | $14,982.00 | $322.20 – $7,553.56 |
| UPMC St. Margaret | Pittsburgh | $35,730.60 | $2,201.26 – $7,285.80 |