CMS Price Transparency Data

Blood test, potassium

Facility: UPMC Presbyterian Shadyside

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $40
Cash Discount Price: $215
vs. Medicare Baseline: 8.40x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at UPMC Presbyterian Shadyside is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 8.40x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$215

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $215 (4517%)

Insurance Median: $40 (840%)

Cash: $215 (4517% of Medicare)

Ins. Median: $40 (840% 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 840% of the Medicare baseline (a markup of 740%). 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 - $8	105%
Amerihealth Caritas	$5 - $10	105%
Cigna	$5	105%
Highmark Wholecare (Prev Gateway)	$5 - $9	105%
Multiplan	$5 - $287	105%
Pa Health & Wellness	$5 - $11	105%
UnitedHealthcare	$5 - $8	105%
Upmc Health Plan	$5 - $7	105%
Upmc Work Partners	$5	105%
Health Partners Plans (Jefferson Health Plan)	$6	126%
Blue Cross Blue Shield	$9 - $40	189%
Geisinger	$10	210%
Preferred Healthcare System	$233	4895%
Coventry/First Health	$251	5273%
Fidelis	$269	5651%
Intergroup	$269 - $305	5651%
Health Coalition Partners	$287	6029%
Private Health Care Systems	$287	6029%
Selectcare	$287	6029%
Health Payors Organization	$305	6408%
Humana	$305	6408%

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 $215.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84132.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Presbyterian Shadyside is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84132.
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.