CMS Price Transparency Data

Blood test, potassium

Facility: UPMC Hamot

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $15
  • Cash Discount Price: $45
  • vs. Medicare Baseline: 3.15x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at UPMC Hamot is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 3.15x the Medicare baseline. Located in 201 State Street, Erie, PA.
Cash / Self-Pay
$45

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.76 (100%)
Cash / Self-Pay: $45 (945%)
Insurance Median: $15 (315%)
Cash: $45 (945% of Medicare)
Ins. Median: $15 (315% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.76 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 315% of the Medicare baseline (a markup of 215%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $5 - $52 105%
Amerihealth Caritas $5 - $10 105%
Blue Cross Blue Shield $5 - $43 105%
Cigna $5 - $30 105%
Fidelis $5 105%
Highmark Wholecare (Prev Gateway) $5 - $38 105%
Independent Health $5 105%
Pa Health & Wellness $5 - $11 105%
UnitedHealthcare $5 - $7 105%
Upmc Health Plan $5 - $8 105%
Upmc Work Partners $5 105%
Wellcare $5 105%
Health Partners Plans (Jefferson Health Plan) $6 126%
Geisinger $9 189%
Univera $11 - $33 231%
Intergroup $49 - $60 1029%
Multiplan $52 - $60 1092%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 State Street, Erie, PA 16550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals