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Ultrasound breast unilateral limited (both sides) at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$280.20
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.
$467.00
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.
$16.44 with Prime Net vs $419.44 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $16.44 | ↓ -94% |
| Keystone Health Plan | Medicare Advantage | $24.00 | ↓ -91% |
| Capital Blue Cross | Medicare Advantage | $24.00 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $46.33 | ↓ -83% |
| Prime Net | Legacy Commercial | $46.80 | ↓ -83% |
| Aetna | ACO | $47.16 | ↓ -83% |
| Prime Net | ACO | $47.16 | ↓ -83% |
| United Healthcare Community Plan for Families | PA Medicaid | $53.63 | ↓ -81% |
| Prime Net | NonGateKeeper | $55.80 | ↓ -80% |
| Aetna | Commercial | $56.16 | ↓ -80% |
| Prime Net | GateKeeper | $56.16 | ↓ -80% |
| Capital Blue Cross | CHIP | $65.64 | ↓ -77% |
| Capital Blue Cross | Commercial | $65.64 | ↓ -77% |
| Keystone Health Plan | Commercial | $65.64 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $66.00 | ↓ -76% |
| Geisinger | Medicaid/CHIP | $66.00 | ↓ -76% |
| Aetna | Medicare | $77.06 | ↓ -72% |
| Wellspan Population Health | PPO | $78.00 | ↓ -72% |
| Geisinger | Commercial | $78.58 | ↓ -72% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $83.39 | ↓ -70% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $83.39 | ↓ -70% |
| UPMC Health Plan | Commercial | $84.00 | ↓ -70% |
| Humana | Medicare | $84.23 | ↓ -70% |
| Highmark Wholecare (prev Gateway) | Medicaid | $86.92 | ↓ -69% |
| United Healthcare | Commercial | $88.32 | ↓ -68% |
| Geisinger | Medicare | $88.44 | ↓ -68% |
| Cigna | Medicare | $88.44 | ↓ -68% |
| UPMC Health Plan | Managed Medicaid | $88.97 | ↓ -68% |
| United Healthcare | Medicare | $90.13 | ↓ -68% |
| Prime Net | FH-Medical Rental | $90.72 | ↓ -68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $90.97 | ↓ -68% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $93.22 | ↓ -67% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $102.00 | ↓ -64% |
| UPMC Work Partners | Workers Comp | $121.46 | ↓ -57% |
| Premier Comp Solutions | Worker's Comp | $121.46 | ↓ -57% |
| Keystone Autism Services | ACAP | $134.77 | ↓ -52% |
| UPMC Health Plan | CHIP | $196.39 | ↓ -30% |
| Highmark BCBS of PA | Community Blue PPO | $236.91 | ↓ -15% |
| Highmark BCBS of PA | CHIP - Managed Care | $246.93 | ↓ -12% |
| Highmark BCBS of PA | Commercial | $263.23 | ↓ -6% |
| Cigna | Commercial | $419.44 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ultrasound breast unilateral limited (both sides) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $253.80 | $34.59 – $338.40 |
| UPMC Bedford | Everett | $291.00 | $30.29 – $436.50 |
| UPMC Northwest | Seneca | $400.20 | $54.53 – $566.95 |
| UPMC Mercy | Pittsburgh | $370.80 | $34.59 – $556.20 |
| UPMC Muncy | Muncy | $479.40 | $52.40 – $639.20 |
| UPMC Passavant-McCandless | Pittsburgh | $894.00 | $34.92 – $1,266.50 |
| UPMC Presbyterian | Pittsburgh | $1,187.40 | $34.92 – $1,682.15 |
| UPMC Somerset | Somerset | $372.60 | $34.24 – $116.07 |