Ustekinumab 45 mg/0.5 ml subcutaneous solution at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$16,705.20
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.
$27,842.00
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.
$82.17 with AmeriHealth Caritas vs $28,373.55 with Health Partners Plans (Jefferson 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 | $82.17 | ↓ -100% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $147.91 | ↓ -99% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $147.91 | ↓ -99% |
| Humana | Medicare | $149.40 | ↓ -99% |
| Aetna | Medicare | $155.82 | ↓ -99% |
| Cigna | Medicare | $156.87 | ↓ -99% |
| Geisinger | Medicare | $156.87 | ↓ -99% |
| United Healthcare | Medicare | $159.86 | ↓ -99% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $161.35 | ↓ -99% |
| UPMC Health Plan | CHIP | $178.65 | ↓ -99% |
| Cigna | Commercial | $217.08 | ↓ -99% |
| Keystone Autism Services | ACAP | $239.04 | ↓ -99% |
| Highmark BCBS of PA | Community Blue PPO | $420.20 | ↓ -97% |
| Highmark BCBS of PA | CHIP - Managed Care | $437.98 | ↓ -97% |
| Highmark BCBS of PA | Commercial | $466.89 | ↓ -97% |
| United Healthcare | Commercial | $1,081.17 | ↓ -94% |
| Prime Net | Managed Medicare | $3,814.35 | ↓ -77% |
| Capital Blue Cross | Medicare Advantage | $5,568.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $5,568.40 | ↓ -67% |
| Capital Blue Cross | Commercial | $8,937.28 | ↓ -47% |
| Keystone Health Plan | Commercial | $8,937.28 | ↓ -47% |
| Capital Blue Cross | CHIP | $8,937.28 | ↓ -47% |
| Prime Net | Legacy Commercial | $10,858.38 | ↓ -35% |
| Aetna | ACO | $10,941.91 | ↓ -34% |
| Prime Net | ACO | $10,941.91 | ↓ -34% |
| UPMC Work Partners | Workers Comp | $11,337.26 | ↓ -32% |
| Prime Net | NonGateKeeper | $12,946.53 | ↓ -23% |
| Prime Net | GateKeeper | $13,030.06 | ↓ -22% |
| Aetna | Commercial | $13,030.06 | ↓ -22% |
| PA Health & Wellness | PA Medicaid HMO | $15,313.10 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $15,313.10 | ↓ -8% |
| Wellspan Population Health | PPO | $18,097.30 | ↑ +8% |
| Geisinger | Commercial | $18,230.94 | ↑ +9% |
| UPMC Health Plan | Commercial | $19,489.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $21,048.55 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $23,665.70 | ↑ +42% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $28,373.55 | ↑ +70% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Ustekinumab 45 mg/0.5 ml subcutaneous solution at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $16,705.20 | $147.91 – $28,373.55 |
| UPMC Hanover | Hanover | $16,705.20 | $147.91 – $28,373.55 |
| UPMC Lititz | Lititz | $16,705.20 | $147.91 – $28,373.55 |
| UPMC Memorial | York | $16,705.20 | $155.82 – $28,373.55 |
| UPMC Somerset | Somerset | $16,705.20 | $147.91 – $161.34 |
| UPMC Northwest | Seneca | not published | $135.49 – $29,792.22 |
| UPMC Mercy | Pittsburgh | not published | $124.54 – $32,629.58 |
| UPMC St. Margaret | Pittsburgh | not published | $128.99 – $31,210.90 |