Transcath closure of asd at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$29,803.20
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.
$49,672.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $53,682.22 with Highmark BCBS of PA — 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 | $1,016.56 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $1,905.08 | ↓ -94% |
| UPMC Health Plan | CHIP | $4,893.78 | ↓ -84% |
| Prime Net | Managed Medicare | $6,805.06 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $9,447.77 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $9,934.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $9,934.40 | ↓ -67% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $17,005.98 | ↓ -43% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $17,005.98 | ↓ -43% |
| Humana | Medicare | $17,177.76 | ↓ -42% |
| Cigna | Commercial | $17,298.00 | ↓ -42% |
| Aetna | Medicare | $17,916.40 | ↓ -40% |
| Geisinger | Medicare | $18,036.65 | ↓ -39% |
| Cigna | Medicare | $18,036.65 | ↓ -39% |
| United Healthcare | Medicare | $18,380.20 | ↓ -38% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18,551.98 | ↓ -38% |
| Prime Net | Legacy Commercial | $19,372.08 | ↓ -35% |
| Prime Net | ACO | $19,521.10 | ↓ -34% |
| Aetna | ACO | $19,521.10 | ↓ -34% |
| Prime Net | NonGateKeeper | $23,097.48 | ↓ -23% |
| Aetna | Commercial | $23,246.50 | ↓ -22% |
| Prime Net | GateKeeper | $23,246.50 | ↓ -22% |
| Keystone Health Plan | Commercial | $27,170.58 | ↓ -9% |
| Capital Blue Cross | CHIP | $27,170.58 | ↓ -9% |
| Capital Blue Cross | Commercial | $27,170.58 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $27,319.60 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $27,319.60 | ↓ -8% |
| Keystone Autism Services | ACAP | $27,484.42 | ↓ -8% |
| Wellspan Population Health | PPO | $32,286.80 | ↑ +8% |
| Geisinger | Commercial | $32,525.23 | ↑ +9% |
| UPMC Health Plan | Commercial | $34,770.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $37,552.03 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $42,221.20 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $48,314.17 | ↑ +62% |
| Highmark BCBS of PA | CHIP - Managed Care | $50,358.32 | ↑ +69% |
| Highmark BCBS of PA | Commercial | $53,682.22 | ↑ +80% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Transcath closure of asd at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $11,757.60 | $1,813.05 – $18,489.15 |
| UPMC Community Osteopathic | Harrisburg | $29,803.20 | $1,016.56 – $42,221.20 |
| UPMC Hamot | Erie | $15,964.20 | $1,813.05 – $24,899.21 |
| UPMC Hanover | Hanover | $29,803.20 | $1,016.56 – $27,446.48 |
| UPMC Lititz | Lititz | $29,803.20 | $1,016.56 – $27,594.74 |
| UPMC Memorial | York | $29,803.20 | $1,016.56 – $27,549.92 |
| UPMC Passavant-McCandless | Pittsburgh | $15,283.20 | $1,820.40 – $18,831.54 |
| UPMC Presbyterian | Pittsburgh | $14,788.80 | $931.20 – $18,831.54 |