healthcosts.net
Venogram ext bil s&i at UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
$3,476.40
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.
$5,794.00
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.
$29.48 with United Healthcare Community Plan for Families vs $8,572.42 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $29.48 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $47.62 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $47.62 | ↓ -99% |
| UPMC Health Plan | Managed Medicaid | $48.75 | ↓ -99% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $51.08 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $54.62 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $63.91 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $271.92 | ↓ -92% |
| Premier Comp Solutions | Worker's Comp | $271.92 | ↓ -92% |
| UPMC Health Plan | CHIP | $415.46 | ↓ -88% |
| Prime Net | Managed Medicare | $793.78 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $1,158.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,158.80 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,471.19 | ↓ -58% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,471.19 | ↓ -58% |
| Humana | Medicare | $1,486.05 | ↓ -57% |
| Aetna | Medicare | $1,549.95 | ↓ -55% |
| Geisinger | Medicare | $1,560.35 | ↓ -55% |
| Cigna | Medicare | $1,560.35 | ↓ -55% |
| United Healthcare | Medicare | $1,590.07 | ↓ -54% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,604.93 | ↓ -54% |
| Prime Net | Legacy Commercial | $2,259.66 | ↓ -35% |
| Prime Net | ACO | $2,277.04 | ↓ -35% |
| Aetna | ACO | $2,277.04 | ↓ -35% |
| Keystone Autism Services | ACAP | $2,377.68 | ↓ -32% |
| Prime Net | NonGateKeeper | $2,694.21 | ↓ -23% |
| Prime Net | GateKeeper | $2,711.59 | ↓ -22% |
| Aetna | Commercial | $2,711.59 | ↓ -22% |
| Capital Blue Cross | CHIP | $3,169.32 | ↓ -9% |
| Keystone Health Plan | Commercial | $3,169.32 | ↓ -9% |
| Capital Blue Cross | Commercial | $3,169.32 | ↓ -9% |
| Wellspan Population Health | PPO | $3,766.10 | ↑ +8% |
| Geisinger | Commercial | $3,793.91 | ↑ +9% |
| UPMC Health Plan | Commercial | $4,055.80 | ↑ +17% |
| Highmark BCBS of PA | Community Blue PPO | $4,179.66 | ↑ +20% |
| United Healthcare | Commercial | $4,264.38 | ↑ +23% |
| Highmark BCBS of PA | CHIP - Managed Care | $4,356.50 | ↑ +25% |
| Prime Net | FH-Medical Rental | $4,380.26 | ↑ +26% |
| Highmark BCBS of PA | Commercial | $4,644.05 | ↑ +34% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,924.90 | ↑ +42% |
| Cigna | Commercial | $8,572.42 | ↑ +147% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Venogram ext bil s&i at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $848.40 | $22.50 – $1,131.20 |
| UPMC Mercy | Pittsburgh | $1,486.20 | $41.25 – $2,229.30 |
| UPMC Muncy | Muncy | $3,953.40 | $28.80 – $5,271.20 |
| UPMC Passavant-McCandless | Pittsburgh | $3,772.20 | $41.25 – $5,343.95 |
| UPMC Presbyterian | Pittsburgh | $10,221.60 | $27.00 – $14,480.60 |
| UPMC Somerset | Somerset | $3,476.40 | $25.88 – $4,345.50 |
| UPMC St. Margaret | Pittsburgh | $1,045.20 | $41.25 – $1,555.07 |
| UPMC Wellsboro | Wellsboro | $4,780.80 | $28.80 – $5,378.40 |