CMS Price Transparency Data

Blood test, calcium

Facility: UPMC Northwest

Billing Code: 82310 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82310
Insurance Median: $25
Cash Discount Price: $37
vs. Medicare Baseline: 4.84x Medicare

The contracted insurance negotiated median rate for a Blood test, calcium at UPMC Northwest is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $5.16, this hospital’s rate is 4.84x the Medicare baseline. Located in 100 Fairfield Drive, Seneca, PA.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$25

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$5.16

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5.16 (100%)

Cash / Self-Pay: $37 (717%)

Insurance Median: $25 (484%)

Cash: $37 (717% of Medicare)

Ins. Median: $25 (484% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5.16 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 484% of the Medicare baseline (a markup of 384%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $40	97%
Blue Cross Blue Shield	$5 - $32	97%
Geisinger	$5	97%
UnitedHealthcare	$5 - $8	97%
Upmc Health Plan	$5 - $8	97%
Upmc Work Partners	$5	97%
Amerihealth Caritas	$6 - $11	116%
Highmark Wholecare (Prev Gateway)	$6 - $11	116%
Pa Health & Wellness	$6 - $12	116%
Cigna	$25 - $40	484%
Intergroup	$40 - $3,704	775%
Coventry/First Health	$43	833%
Health Coalition Partners	$45	872%
Private Health Care Systems	$50	969%
Humana	$53	1027%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $37.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82310.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Northwest is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82310.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.