UPMC · Carlisle, PA
33
In-network payers
292
Disclosed rate categories
165
Beds
3
Care quality
Upmc Carlisle is a 165-bed proprietary hospital in Carlisle, PA, affiliated with UPMC. Below you'll find publicly disclosed negotiated rates and facility details, including 33 in-network payers and 292 disclosed rate categories.
CCN (Medicare provider number)
390058
NPI
1689107328
Type
Short Term Acute Care Hospital
Ownership
Proprietary
Beds
165
Care Quality
3
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Upmc Carlisle most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$9,598 - $15,646
from 3 insurers · median $13,271
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$14,623 - $21,951
from 3 insurers · median $18,323
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Medicine & Surgery · Inpatient
MS-DRG 470
$32,982 - $46,000
from 3 insurers · median $40,890
34 Medicare discharges for this DRG in CMS hospital data
Medicine & Surgery
CPT 47562
$7,145 - $46,495
from 3 insurers · median $16,693
91 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 74177
$1,081 - $3,662
from 4 insurers · median $1,978
Common here, based on CMS Medicare volume
Digestive procedures
CPT 47563
$7,995 - $16,693
from 3 insurers · median $15,294
91 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Cardiology and vascular testing
CPT 93306
$1,719 - $2,259
from 4 insurers · median $1,828
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$9,598 - $15,646
from 3 insurers · median $13,271
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Digestive procedures
CPT 49650
$5,197 - $15,300
from 3 insurers · median $6,971
91 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Mammography
CPT 77067
$316 - $445
from 3 insurers · median $401
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$980 - $5,035
from 2 insurers · median $3,007
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$517 - $977
from 3 insurers · median $610
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 460
$64,224 - $75,286
from 2 insurers · median $69,755
Hospital reports neurosurgical services to CMS
CT imaging
CPT 74176
$1,230 - $1,340
from 3 insurers · median $1,315
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$1,089 - $5,035
from 3 insurers · median $3,169
Common here, based on CMS Medicare volume
Urology
CPT 50590
$9,452 - $22,606
from 3 insurers · median $16,693
62 Medicare claims in Level 4 Urology and Related Services (CMS 2024)
Nuclear imaging
CPT 78452
$3,131 - $5,870
from 4 insurers · median $4,623
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$12,273 - $46,495
from 3 insurers · median $16,693
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$1,782 - $9,812
from 3 insurers · median $6,286
128 Medicare claims in Level 1 Intraocular Procedures (CMS 2024)
Nuclear imaging
CPT 78815
$4,371 - $7,619
from 4 insurers · median $5,699
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 473
$39,748 - $59,572
from 3 insurers · median $52,922
Hospital reports neurosurgical services to CMS
MRI imaging
CPT 70553
$1,123 - $3,502
from 4 insurers · median $2,082
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$550 - $1,747
from 4 insurers · median $975
Common here, based on CMS Medicare volume
Orthopedics and pain
CPT 63030
$4,982 - $22,906
from 3 insurers · median $16,693
61 Medicare claims in Level 4 Musculoskeletal Procedures (CMS 2024)
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 15 | 540% | 4 | 5 |
| Insurer B* | 23 | 430% | 5 | 3 |
| Insurer C* | 20 | 306% | 4 | 10 |
| Insurer D* | 18 | 268% | 11 | 6 |
How we chose these services: 7 appear in this hospital's own Medicare claims, 11 are common here based on CMS Medicare volume, and 6 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Upmc Carlisle.
361 Alexander Spring Road, Carlisle, PA 17015
(717) 249-1212
The nearest hospitals of similar type and size. Their rates are compared with Upmc Carlisle for the same insurers and services above.
Holy Spirit Hospital
▼ Rates typically 12% lower than Upmc Carlisle (21 services)
The Chambersburg Hospital
▲ Rates typically 50% higher than Upmc Carlisle (20 services)
Geisinger Lewistown Hospital
▲ Rates typically 11% higher than Upmc Carlisle (20 services)
Meritus Medical Center
▼ Rates typically 40% lower than Upmc Carlisle (15 services)
Carroll Hospital
▼ Rates typically 33% lower than Upmc Carlisle (14 services)
Wellspan Good Samaritan Hospital
▼ Rates typically 18% lower than Upmc Carlisle (20 services)
Upmc East
Upmc Mckeesport
Upmc Northwest
Upmc Lititz
About Upmc Carlisle's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Upmc Carlisle range from $1,123 to $3,502 across 4 insurers. UnitedHealthcare's rate is $3,502. The median at nearby comparable hospitals is $1,598. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Upmc Carlisle range from $1,081 to $3,662 across 4 insurers. Aetna's rate is $2,193. The median at nearby comparable hospitals is $1,443. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Upmc Carlisle range from $980 to $5,035 across 2 insurers. Cigna's rate is $5,035. The median at nearby comparable hospitals is $2,935. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Upmc Carlisle range from $9,598 to $15,646 across 3 insurers. UnitedHealthcare's rate is $13,271. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Upmc Carlisle range from $316 to $445 across 3 insurers. Cigna's rate is $445. The median at nearby comparable hospitals is $335. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Upmc Carlisle range from $32,982 to $46,000 across 3 insurers. Blue Cross Blue Shield's rate is $32,982. The median at nearby comparable hospitals is $39,813. What a patient pays depends on their plan's deductible, coinsurance and network status.
Upmc Carlisle has 165 beds. Facility type: Short Term Acute Care Hospital.
Upmc Carlisle is located at 361 Alexander Spring Road, Carlisle, PA 17015. Its main phone number is (717) 249-1212.
Upmc Carlisle's CMS Certification Number (CCN), also called its Medicare provider number, is 390058.
The National Provider Identifier (NPI) on file for Upmc Carlisle is 1689107328.
Upmc Carlisle is affiliated with UPMC.
Upmc Carlisle lists 33 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
292 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers