Tissue exam koh skin/hair/nails at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$238.80
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.
$398.00
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.
$3.42 with Prime Net vs $30.35 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 | $3.42 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $3.90 | ↓ -98% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $4.23 | ↓ -98% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $4.23 | ↓ -98% |
| Humana | Medicare | $4.27 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $4.42 | ↓ -98% |
| Aetna | Medicare | $4.45 | ↓ -98% |
| Cigna | Medicare | $4.48 | ↓ -98% |
| Geisinger | Medicare | $4.48 | ↓ -98% |
| United Healthcare | Medicare | $4.57 | ↓ -98% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $4.61 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $4.95 | ↓ -98% |
| Capital Blue Cross | Medicare Advantage | $5.00 | ↓ -98% |
| Keystone Health Plan | Medicare Advantage | $5.00 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $5.07 | ↓ -98% |
| United Healthcare Community Plan for Families | PA Medicaid | $5.11 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $5.31 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $5.68 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $6.65 | ↓ -97% |
| Keystone Autism Services | ACAP | $6.83 | ↓ -97% |
| United Healthcare | Commercial | $6.98 | ↓ -97% |
| Prime Net | Legacy Commercial | $9.75 | ↓ -96% |
| Aetna | ACO | $9.82 | ↓ -96% |
| Prime Net | ACO | $9.82 | ↓ -96% |
| Cigna | Commercial | $11.12 | ↓ -95% |
| Prime Net | NonGateKeeper | $11.62 | ↓ -95% |
| Aetna | Commercial | $11.70 | ↓ -95% |
| Prime Net | GateKeeper | $11.70 | ↓ -95% |
| Highmark BCBS of PA | Community Blue PPO | $12.01 | ↓ -95% |
| Highmark BCBS of PA | CHIP - Managed Care | $12.52 | ↓ -95% |
| Highmark BCBS of PA | Commercial | $13.34 | ↓ -94% |
| Capital Blue Cross | CHIP | $13.68 | ↓ -94% |
| Capital Blue Cross | Commercial | $13.68 | ↓ -94% |
| Keystone Health Plan | Commercial | $13.68 | ↓ -94% |
| Wellspan Population Health | PPO | $16.25 | ↓ -93% |
| Geisinger | Commercial | $16.37 | ↓ -93% |
| UPMC Health Plan | Commercial | $17.50 | ↓ -93% |
| Prime Net | FH-Medical Rental | $18.90 | ↓ -92% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $21.25 | ↓ -91% |
| UPMC Health Plan | CHIP | $30.35 | ↓ -87% |
Visitor-reported prices
Comments
Tissue exam koh skin/hair/nails at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $37.80 | $3.90 – $50.40 |
| UPMC Bedford | Everett | $33.00 | $1.54 – $49.50 |
| UPMC Cole | Coudersport | $35.40 | $2.78 – $47.20 |
| UPMC Community Osteopathic | Harrisburg | $238.80 | $3.90 – $30.35 |
| UPMC Hamot | Erie | $55.20 | $3.90 – $8.68 |
| UPMC Northwest | Seneca | $33.00 | $3.87 – $4.61 |
| UPMC Hanover | Hanover | $238.80 | $3.90 – $6.83 |
| UPMC Horizon-Greenville | Greenville | $70.20 | $3.82 – $8.01 |