Treat thumb fracture at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$4,728.00
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.
$7,880.00
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 $9,699.87 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 | ↓ -78% |
| Prime Net | Managed Medicare | $1,079.56 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $1,545.94 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,576.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,576.00 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,707.12 | ↓ -64% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $3,072.82 | ↓ -35% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $3,072.82 | ↓ -35% |
| Prime Net | Legacy Commercial | $3,073.20 | ↓ -35% |
| Aetna | ACO | $3,096.84 | ↓ -35% |
| Prime Net | ACO | $3,096.84 | ↓ -35% |
| Humana | Medicare | $3,103.86 | ↓ -34% |
| Aetna | Medicare | $3,237.33 | ↓ -32% |
| Cigna | Medicare | $3,259.05 | ↓ -31% |
| Geisinger | Medicare | $3,259.05 | ↓ -31% |
| UPMC Health Plan | CHIP | $3,267.21 | ↓ -31% |
| United Healthcare | Medicare | $3,321.13 | ↓ -30% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,352.17 | ↓ -29% |
| Prime Net | NonGateKeeper | $3,664.20 | ↓ -23% |
| Aetna | Commercial | $3,687.84 | ↓ -22% |
| Prime Net | GateKeeper | $3,687.84 | ↓ -22% |
| Capital Blue Cross | CHIP | $4,310.36 | ↓ -9% |
| Capital Blue Cross | Commercial | $4,310.36 | ↓ -9% |
| Keystone Health Plan | Commercial | $4,310.36 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $4,334.00 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $4,334.00 | ↓ -8% |
| Keystone Autism Services | ACAP | $4,966.18 | ↑ +5% |
| Wellspan Population Health | PPO | $5,122.00 | ↑ +8% |
| Geisinger | Commercial | $5,159.82 | ↑ +9% |
| UPMC Health Plan | Commercial | $5,516.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $5,957.28 | ↑ +26% |
| Cigna | Commercial | $6,146.40 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $6,698.00 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $8,729.92 | ↑ +85% |
| Highmark BCBS of PA | CHIP - Managed Care | $9,099.28 | ↑ +92% |
| Highmark BCBS of PA | Commercial | $9,699.87 | ↑ +105% |
| 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
Treat thumb fracture at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $4,728.00 | $1,016.56 – $6,698.00 |
| UPMC Hanover | Hanover | $4,728.00 | $1,016.56 – $4,959.33 |
| UPMC Lititz | Lititz | $4,728.00 | $1,016.56 – $4,986.11 |
| UPMC Memorial | York | $4,728.00 | $840.28 – $4,978.02 |
| UPMC Somerset | Somerset | $4,728.00 | $892.40 – $3,340.51 |
| UPMC Altoona | Altoona | not published | $1,030.96 – $3,340.82 |
| WellSpan Chambersburg Hospital | Chambersburg | not published | $970.00 – $14,922.27 |
| WellSpan Surgery & Rehabilitation Hospital | York PA 17403 | not published | $970.00 – $1,101.92 |