healthcosts.net
Transcath mv repair addl prosthesis at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$4,354.20
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.
$7,257.00
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.
$334.43 with United Healthcare Community Plan for Families vs $9,539.00 with Cigna — 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 | $334.43 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $808.05 | ↓ -81% |
| Prime Net | Managed Medicare | $994.21 | ↓ -77% |
| Aetna | Medicare | $1,197.40 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $1,451.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,451.40 | ↓ -67% |
| Prime Net | Legacy Commercial | $2,830.23 | ↓ -35% |
| Aetna | ACO | $2,852.00 | ↓ -35% |
| Prime Net | ACO | $2,852.00 | ↓ -35% |
| Prime Net | NonGateKeeper | $3,374.51 | ↓ -22% |
| Aetna | Commercial | $3,396.28 | ↓ -22% |
| Prime Net | GateKeeper | $3,396.28 | ↓ -22% |
| Keystone Health Plan | Commercial | $3,969.58 | ↓ -9% |
| Capital Blue Cross | Commercial | $3,969.58 | ↓ -9% |
| Capital Blue Cross | CHIP | $3,969.58 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $3,991.35 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $3,991.35 | ↓ -8% |
| Wellspan Population Health | PPO | $4,717.05 | ↑ +8% |
| Geisinger | Commercial | $4,751.88 | ↑ +9% |
| UPMC Health Plan | CHIP | $5,079.90 | ↑ +17% |
| UPMC Health Plan | Commercial | $5,079.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $5,486.29 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $6,168.45 | ↑ +42% |
| Cigna | Commercial | $9,539.00 | ↑ +119% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Transcath mv repair addl prosthesis at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $2,269.20 | $303.81 – $3,214.70 |
| UPMC Somerset | Somerset | $4,354.20 | $293.58 – $5,442.75 |