CMS Price Transparency Data

Blood test, vitamin D

Facility: UPMC Northwest

Billing Code: 82306 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82306
Insurance Median: $119
Cash Discount Price: $146
vs. Medicare Baseline: 4.02x Medicare

The contracted insurance negotiated median rate for a Blood test, vitamin D at UPMC Northwest is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $29.6, this hospital’s rate is 4.02x the Medicare baseline. Located in 100 Fairfield Drive, Seneca, PA.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$29.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.6 (100%)

Cash / Self-Pay: $146 (493%)

Insurance Median: $119 (402%)

Cash: $146 (493% of Medicare)

Ins. Median: $119 (402% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $29.6 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 402% of the Medicare baseline (a markup of 302%). 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	$27 - $48	91%
Upmc Work Partners	$29	98%
Aetna	$30 - $158	101%
Blue Cross Blue Shield	$30 - $183	101%
Geisinger	$30	101%
UnitedHealthcare	$31 - $47	105%
Amerihealth Caritas	$32 - $64	108%
Highmark Wholecare (Prev Gateway)	$32 - $61	108%
Pa Health & Wellness	$32 - $70	108%
Cigna	$97 - $158	328%
Intergroup	$158 - $3,704	534%
Coventry/First Health	$170	574%
Health Coalition Partners	$175	591%
Private Health Care Systems	$194	655%
Humana	$207	699%

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 $146.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82306.

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 82306.
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.