UPMC Health Plan
Last updated: March 2026
UPMC Health Plan is a health insurer. They report 3K insurance plans covering 61K providers across 13K billing codes.
Data Version
Price Transparency Machine-Readable Files Snapshot
Overview
3K
Plans
61K
Providers (NPIs)
XX% vs prev8.3K
Tax IDs
XX% vs prev13K
Billing Codes
XX% vs prev10M
Data Rows
XX% vs prevGeographic Coverage
Top states by provider count:
Data Breakdown
Plans Type (HIOS vs EIN)
HIOS | 160 |
EIN | 2.8K |
NPIs
Individual | 54K |
Group | 7.3K |
Tax IDs
EIN | 7.6K |
NPI (Individual) | 770 |
NPI (Group) | 5 |
Billing Code Type
| Codes | Rows | |
|---|---|---|
CPT | 8.9K | 7.8M |
HCPCS | 3.1K | 2.5M |
MS-DRG | 700 | 110K |
HIPPS | 2 | 1.3K |
RC | 21 | 240 |
Billing Class
| Rows | |
|---|---|
Professional | 10M |
Institutional | 180K |
Negotiated Type
| Rows | |
|---|---|
Negotiated | 10M |
Per Diem | 14K |
Percentage | 700 |
Top States by # NPIs
Pennsylvania | 46K |
Ohio | 7.3K |
New York | 1.7K |
Maryland | 910 |
West Virginia | 820 |
Top Taxonomies by # NPIs
Physician Assistant | 4.4K |
Family Medicine Physician | 3.6K |
Internal Medicine Physician | 3.2K |
Certified Registered Nurse Anesthetist | 2.8K |
Professional Counselor | 2.6K |
Want to explore UPMC Health Plan's actual negotiated rates?
See code-level rates by provider, specialty, and geography.
Historical Metrics
| Month | Plans | NPIs | Tax IDs | Billing Codes | Data Rows |
|---|---|---|---|---|---|
March 2026 | 3K | 61K | 8.3K | 13K | 10M |
February 2026 | 3K | 71K | 9.3K | 14K | 32M |
January 2026 | — | — | — | — | |
December 2025 | — | — | — | — | |
November 2025 | — | — | — | — |
Show all 12 months
Data Coverage Scorecard
This payer meets all 6 data quality criteria — their transparency files are comprehensive and well-structured.
Professional & Institutional Rates
Data includes both professional and institutional billing class rates
Valid Tax IDs
More than 80% of Tax IDs are EIN or NPI (Organization) type
HIOS Plan
Data includes at least one HIOS-identified plan
Low Derived/Percentage Rates
Less than 10% of negotiation entries are derived or percentage type
Standard Code Coverage
Sufficient CPT and HCPCS code coverage with low proportion of LOCAL entries
Common Taxonomies
NPIs in the dataset cover at least 50 distinct provider taxonomies
Methodology
The scorecard evaluates each payer's monthly price transparency data against six quality criteria:
If 5–6 criteria pass, the overall rating is Good.
If 3–4 criteria pass, the rating is Acceptable.
If 0–2 criteria pass, the rating is Poor.
Behavioral, RX, and other specialty networks may not pass all criteria but can still contain complete and usable data.