Vaccine dtap < 7 years im at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$32.40
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.
$54.00
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.
$7.40 with Prime Net vs $71.62 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $7.40 | ↓ -77% |
| Aetna | Medicare | $8.91 | ↓ -73% |
| United Healthcare Community Plan for Families | PA Medicaid | $10.50 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $10.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $10.80 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $12.70 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicaid | $12.70 | ↓ -61% |
| UPMC Health Plan | Managed Medicaid | $13.00 | ↓ -60% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $13.62 | ↓ -58% |
| Geisinger | Medicaid/CHIP | $14.57 | ↓ -55% |
| PA Health & Wellness | PA Medicaid HMO | $17.04 | ↓ -47% |
| Capital Blue Cross | CHIP | $17.33 | ↓ -47% |
| Capital Blue Cross | Commercial | $17.33 | ↓ -47% |
| Keystone Health Plan | Commercial | $17.33 | ↓ -47% |
| Prime Net | Legacy Commercial | $21.06 | ↓ -35% |
| Prime Net | ACO | $21.22 | ↓ -35% |
| Aetna | ACO | $21.22 | ↓ -35% |
| UPMC Work Partners | Workers Comp | $21.99 | ↓ -32% |
| Prime Net | NonGateKeeper | $25.11 | ↓ -23% |
| Prime Net | GateKeeper | $25.27 | ↓ -22% |
| Aetna | Commercial | $25.27 | ↓ -22% |
| United Healthcare | Commercial | $33.26 | ↑ +3% |
| Wellspan Population Health | PPO | $35.10 | ↑ +8% |
| Geisinger | Commercial | $35.36 | ↑ +9% |
| UPMC Health Plan | Commercial | $37.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $40.82 | ↑ +26% |
| Cigna | Commercial | $44.25 | ↑ +37% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $45.90 | ↑ +42% |
| UPMC Health Plan | CHIP | $71.62 | ↑ +121% |
Visitor-reported prices
Comments
Vaccine dtap < 7 years im at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $32.40 | $10.00 – $106.14 |
| UPMC Community Osteopathic | Harrisburg | $32.40 | $10.50 – $71.62 |
| UPMC Hamot | Erie | $43.20 | $11.00 – $93.98 |
| UPMC Hanover | Hanover | $32.40 | $10.50 – $44.25 |
| UPMC Horizon-Greenville | Greenville | $43.20 | $10.50 – $52.21 |
| UPMC Jameson | New Castle | $43.20 | $11.00 – $31.20 |
| UPMC Kane | Kane | $75.60 | $11.00 – $58.38 |
| UPMC Lititz | Lititz | $32.40 | $10.50 – $44.25 |