CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: UPMC Northwest

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84443
Insurance Median: $72
Cash Discount Price: $89
vs. Medicare Baseline: 4.29x Medicare

The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at UPMC Northwest is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 4.29x the Medicare baseline. Located in 100 Fairfield Drive, Seneca, PA.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$16.8

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $16.8 (100%)

Cash / Self-Pay: $89 (530%)

Insurance Median: $72 (429%)

Cash: $89 (530% of Medicare)

Ins. Median: $72 (429% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $16.8 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 429% of the Medicare baseline (a markup of 329%). 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
Upmc Health Plan	$15 - $28	89%
Aetna	$17 - $97	101%
Blue Cross Blue Shield	$17 - $104	101%
Geisinger	$17	101%
Upmc Work Partners	$17	101%
Amerihealth Caritas	$18 - $36	107%
Highmark Wholecare (Prev Gateway)	$18 - $34	107%
Pa Health & Wellness	$18 - $40	107%
UnitedHealthcare	$18 - $27	107%
Cigna	$60 - $97	357%
Intergroup	$97 - $3,704	577%
Coventry/First Health	$104	619%
Health Coalition Partners	$107	637%
Private Health Care Systems	$119	708%
Humana	$127	756%

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 $89.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84443.

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 84443.
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.