Tx tarsal bone fx without manip 28450 at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$509.40
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.
$849.00
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.
$116.31 with Prime Net vs $1,016.56 with United Healthcare Community Plan for Families — 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 | $116.31 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $144.78 | ↓ -72% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $144.78 | ↓ -72% |
| UPMC Health Plan | Managed Medicaid | $148.20 | ↓ -71% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $155.27 | ↓ -70% |
| Geisinger | Medicaid/CHIP | $166.05 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $169.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $169.80 | ↓ -67% |
| PA Health & Wellness | PA Medicaid HMO | $194.28 | ↓ -62% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $227.18 | ↓ -55% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $227.18 | ↓ -55% |
| Humana | Medicare | $229.47 | ↓ -55% |
| Aetna | Medicare | $239.34 | ↓ -53% |
| Geisinger | Medicare | $240.94 | ↓ -53% |
| Cigna | Medicare | $240.94 | ↓ -53% |
| United Healthcare | Medicare | $245.53 | ↓ -52% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.83 | ↓ -51% |
| Prime Net | Legacy Commercial | $331.11 | ↓ -35% |
| Prime Net | ACO | $333.66 | ↓ -34% |
| Aetna | ACO | $333.66 | ↓ -34% |
| Keystone Autism Services | ACAP | $367.15 | ↓ -28% |
| UPMC Work Partners | Workers Comp | $390.75 | ↓ -23% |
| Prime Net | NonGateKeeper | $394.79 | ↓ -22% |
| Aetna | Commercial | $397.33 | ↓ -22% |
| Prime Net | GateKeeper | $397.33 | ↓ -22% |
| UPMC Health Plan | CHIP | $419.61 | ↓ -18% |
| Keystone Health Plan | Commercial | $464.40 | ↓ -9% |
| Capital Blue Cross | CHIP | $464.40 | ↓ -9% |
| Capital Blue Cross | Commercial | $464.40 | ↓ -9% |
| Wellspan Population Health | PPO | $551.85 | ↑ +8% |
| Geisinger | Commercial | $555.93 | ↑ +9% |
| UPMC Health Plan | Commercial | $594.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $641.84 | ↑ +26% |
| Highmark BCBS of PA | Community Blue PPO | $645.41 | ↑ +27% |
| Cigna | Commercial | $662.22 | ↑ +30% |
| Highmark BCBS of PA | CHIP - Managed Care | $672.71 | ↑ +32% |
| Highmark BCBS of PA | Commercial | $717.12 | ↑ +41% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $721.65 | ↑ +42% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +100% |
| 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
Tx tarsal bone fx without manip 28450 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $682.80 | $49.90 – $373.39 |
| UPMC Community Osteopathic | Harrisburg | $509.40 | $144.78 – $1,016.56 |
| UPMC Hanover | Hanover | $509.40 | $144.78 – $1,016.56 |
| UPMC Lititz | Lititz | $509.40 | $144.78 – $1,016.56 |
| UPMC Memorial | York | $509.40 | $106.05 – $1,016.56 |
| UPMC Muncy | Muncy | $825.60 | $125.40 – $993.28 |
| UPMC Somerset | Somerset | $509.40 | $125.40 – $892.40 |
| UPMC Wellsboro | Wellsboro | $825.60 | $125.40 – $993.28 |