Tissue culture skin/biopsy at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$1,007.40
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.
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What you pay up front if you don't use insurance.
$1,679.00
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.
$139.32 with Highmark BCBS of PA vs $1,427.15 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 BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $139.32 | ↓ -86% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $139.32 | ↓ -86% |
| Humana | Medicare | $140.73 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $145.55 | ↓ -86% |
| Aetna | Medicare | $146.78 | ↓ -85% |
| Cigna | Medicare | $147.77 | ↓ -85% |
| Geisinger | Medicare | $147.77 | ↓ -85% |
| United Healthcare | Medicare | $150.58 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $151.99 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $189.00 | ↓ -81% |
| Keystone Autism Services | ACAP | $225.17 | ↓ -78% |
| Prime Net | Managed Medicare | $230.02 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $240.03 | ↓ -76% |
| UPMC Health Plan | Managed Medicaid | $245.70 | ↓ -76% |
| United Healthcare Community Plan for Families | PA Medicaid | $247.59 | ↓ -75% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $257.42 | ↓ -74% |
| Geisinger | Medicaid/CHIP | $275.30 | ↓ -73% |
| PA Health & Wellness | PA Medicaid HMO | $322.09 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $335.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $335.80 | ↓ -67% |
| Cigna | Commercial | $365.88 | ↓ -64% |
| Highmark BCBS of PA | Community Blue PPO | $395.82 | ↓ -61% |
| Highmark BCBS of PA | CHIP - Managed Care | $412.56 | ↓ -59% |
| Highmark BCBS of PA | Commercial | $439.80 | ↓ -56% |
| Prime Net | Legacy Commercial | $654.81 | ↓ -35% |
| Prime Net | ACO | $659.85 | ↓ -34% |
| Aetna | ACO | $659.85 | ↓ -34% |
| Prime Net | NonGateKeeper | $780.74 | ↓ -22% |
| Aetna | Commercial | $785.77 | ↓ -22% |
| Prime Net | GateKeeper | $785.77 | ↓ -22% |
| Capital Blue Cross | CHIP | $918.41 | ↓ -9% |
| Keystone Health Plan | Commercial | $918.41 | ↓ -9% |
| Capital Blue Cross | Commercial | $918.41 | ↓ -9% |
| UPMC Health Plan | CHIP | $1,086.79 | ↑ +8% |
| Wellspan Population Health | PPO | $1,091.35 | ↑ +8% |
| Geisinger | Commercial | $1,099.41 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,175.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,269.32 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,427.15 | ↑ +42% |
Visitor-reported prices
Comments
Tissue culture skin/biopsy at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,299.00 | $139.08 – $1,732.00 |
| UPMC Bedford | Everett | $1,359.60 | $50.78 – $2,039.40 |
| UPMC Cole | Coudersport | $635.40 | $53.00 – $847.20 |
| UPMC Community Osteopathic | Harrisburg | $1,007.40 | $139.32 – $1,427.15 |
| UPMC East | Monroeville | $2,340.60 | $139.08 – $3,120.80 |
| UPMC Hamot | Erie | $1,636.80 | $139.08 – $382.52 |
| UPMC Northwest | Seneca | $1,296.60 | $127.63 – $217.35 |
| UPMC Hanover | Hanover | $1,007.40 | $139.32 – $257.42 |