CMS Price Transparency Data

Blood test, potassium

Facility: UPMC Northwest

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $23
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 4.83x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at UPMC Northwest is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 4.83x the Medicare baseline. Located in 100 Fairfield Drive, Seneca, PA.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $35 (735%)
Insurance Median: $23 (483%)
Cash: $35 (735% of Medicare)
Ins. Median: $23 (483% 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 483% of the Medicare baseline (a markup of 383%). 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
Upmc Health Plan $4 - $7 84%
Aetna $5 - $38 105%
Amerihealth Caritas $5 - $10 105%
Blue Cross Blue Shield $5 - $29 105%
Geisinger $5 105%
Highmark Wholecare (Prev Gateway) $5 - $9 105%
Pa Health & Wellness $5 - $11 105%
UnitedHealthcare $5 - $7 105%
Upmc Work Partners $5 105%
Cigna $23 - $38 483%
Intergroup $38 - $3,704 798%
Coventry/First Health $41 861%
Health Coalition Partners $42 882%
Private Health Care Systems $46 966%
Humana $49 1029%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Fairfield Drive, Seneca, PA 16346
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals