Treatment of thigh fracture at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$621.60
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.
$1,036.00
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.
$126.21 with AmeriHealth Caritas vs $2,316.44 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $126.21 | ↓ -80% |
| Prime Net | Managed Medicare | $141.93 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $207.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $207.20 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $227.18 | ↓ -63% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $227.18 | ↓ -63% |
| Humana | Medicare | $229.47 | ↓ -63% |
| Aetna | Medicare | $239.34 | ↓ -61% |
| Cigna | Medicare | $240.94 | ↓ -61% |
| Geisinger | Medicare | $240.94 | ↓ -61% |
| United Healthcare | Medicare | $245.53 | ↓ -61% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.83 | ↓ -60% |
| Keystone Autism Services | ACAP | $367.15 | ↓ -41% |
| Prime Net | Legacy Commercial | $404.04 | ↓ -35% |
| Aetna | ACO | $407.15 | ↓ -34% |
| Prime Net | ACO | $407.15 | ↓ -34% |
| Prime Net | NonGateKeeper | $481.74 | ↓ -23% |
| Aetna | Commercial | $484.85 | ↓ -22% |
| Prime Net | GateKeeper | $484.85 | ↓ -22% |
| Keystone Health Plan | Commercial | $566.69 | ↓ -9% |
| Capital Blue Cross | CHIP | $566.69 | ↓ -9% |
| Capital Blue Cross | Commercial | $566.69 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $569.80 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $569.80 | ↓ -8% |
| Highmark BCBS of PA | Community Blue PPO | $645.41 | ↑ +4% |
| Highmark BCBS of PA | CHIP - Managed Care | $672.71 | ↑ +8% |
| Wellspan Population Health | PPO | $673.40 | ↑ +8% |
| Geisinger | Commercial | $678.37 | ↑ +9% |
| Highmark BCBS of PA | Commercial | $717.12 | ↑ +15% |
| UPMC Health Plan | Commercial | $725.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $783.22 | ↑ +26% |
| Cigna | Commercial | $808.08 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $880.60 | ↑ +42% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +64% |
| UPMC Work Partners | Workers Comp | $1,269.65 | ↑ +104% |
| UPMC Health Plan | CHIP | $2,316.44 | ↑ +273% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Treatment of thigh fracture at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,693.20 | $366.46 – $1,213.22 |
| UPMC Community Osteopathic | Harrisburg | $621.60 | $207.20 – $2,316.44 |
| UPMC Hamot | Erie | $4,193.40 | $263.94 – $1,248.23 |
| UPMC Hanover | Hanover | $621.60 | $226.87 – $2,316.44 |
| UPMC Lititz | Lititz | $621.60 | $228.10 – $2,316.44 |
| UPMC Memorial | York | $621.60 | $239.91 – $2,316.44 |
| UPMC Muncy | Muncy | $633.60 | $993.28 – $1,335.32 |
| UPMC Somerset | Somerset | $621.60 | $226.41 – $1,213.22 |