Upgrade pm system at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$15,540.60
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.
$25,901.00
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 $38,529.29 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $1,313.23 | ↓ -92% |
| Prime Net | Managed Medicare | $3,548.44 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $5,180.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $5,180.20 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $5,506.24 | ↓ -65% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $9,911.23 | ↓ -36% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $9,911.23 | ↓ -36% |
| Humana | Medicare | $10,011.34 | ↓ -36% |
| Prime Net | Legacy Commercial | $10,101.39 | ↓ -35% |
| Aetna | ACO | $10,179.09 | ↓ -35% |
| Prime Net | ACO | $10,179.09 | ↓ -35% |
| Aetna | Medicare | $10,441.83 | ↓ -33% |
| Cigna | Medicare | $10,511.91 | ↓ -32% |
| Geisinger | Medicare | $10,511.91 | ↓ -32% |
| United Healthcare | Medicare | $10,712.13 | ↓ -31% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10,812.25 | ↓ -30% |
| Prime Net | NonGateKeeper | $12,043.97 | ↓ -22% |
| Prime Net | GateKeeper | $12,121.67 | ↓ -22% |
| Aetna | Commercial | $12,121.67 | ↓ -22% |
| Capital Blue Cross | CHIP | $14,167.85 | ↓ -9% |
| Capital Blue Cross | Commercial | $14,167.85 | ↓ -9% |
| Keystone Health Plan | Commercial | $14,167.85 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $14,245.55 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $14,245.55 | ↓ -8% |
| Keystone Autism Services | ACAP | $16,018.14 | ↑ +3% |
| Wellspan Population Health | PPO | $16,835.65 | ↑ +8% |
| Geisinger | Commercial | $16,959.97 | ↑ +9% |
| Cigna | Commercial | $17,298.00 | ↑ +11% |
| UPMC Health Plan | Commercial | $18,130.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $19,581.16 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $22,015.85 | ↑ +42% |
| Highmark BCBS of PA | Community Blue PPO | $28,157.89 | ↑ +81% |
| Highmark BCBS of PA | CHIP - Managed Care | $29,349.24 | ↑ +89% |
| Highmark BCBS of PA | Commercial | $31,286.44 | ↑ +101% |
| UPMC Health Plan | CHIP | $38,529.29 | ↑ +148% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Upgrade pm system at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $14,761.80 | $893.69 – $19,682.40 |
| UPMC Community Osteopathic | Harrisburg | $15,540.60 | $1,016.56 – $38,529.29 |
| UPMC Hamot | Erie | $12,843.00 | $893.69 – $14,511.47 |
| UPMC Hanover | Hanover | $15,540.60 | $1,016.56 – $38,529.29 |
| UPMC Lititz | Lititz | $15,540.60 | $1,016.56 – $38,529.29 |
| UPMC Memorial | York | $15,540.60 | $728.40 – $38,529.29 |
| UPMC Somerset | Somerset | $15,540.60 | $884.65 – $10,774.64 |
| UPMC Williamsport | Williamsport | $5,231.40 | $993.28 – $10,775.64 |