CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Sonoma Valley Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $39
  • Cash Discount Price: $142
  • vs. Medicare Baseline: 12.30x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Sonoma Valley Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 12.30x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$142

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$3.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3.17 (100%)
Cash / Self-Pay: $142 (4479%)
Insurance Median: $39 (1230%)
Cash: $142 (4479% of Medicare)
Ins. Median: $39 (1230% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3.17 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 1230% of the Medicare baseline (a markup of 1130%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $3 - $203 95%
Bright Hlth/Brand New Day Mcr Adv $3 95%
Hospice Of Marin-All Plans $3 95%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $3 95%
St Joseph Heritage Hltcare Comm-All Other Plans $3 95%
Tricare $3 95%
Veterans Admin-All Plans $3 95%
Bright Hlth/Brand New Day - All Other Plands $4 126%
Cdcr Prison-All Plans $4 126%
Chp - Correctional Health Partners - All Plans $4 126%
Medi-Cal $4 126%
Partnership Healthplan-All Plans $4 126%
Three Rivers (Trpn)-All Plans $4 126%
Wellpath - All Plans $4 126%
Aetna $5 158%
First Health(Coventry)-All Plans $5 158%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $6 189%
Canopy Health Solutions-All Other Plans $6 189%
Mcal Mgd Care (Php)-All Plans $6 189%
Meritage Medical Network Op Only Mcare $6 189%
Meritage Medical Network Op Only-All Other Plans $6 189%
UnitedHealthcare $6 189%
Healthnet Hmo/Ppo-All Other Plans $71 2240%
Blue Shield Ppo-All Plans $115 3628%
Kaiser-All Plans $132 4164%
Integrated Health Plan-All Plans $150 4732%
Champus-All Plans $162 5110%
Cigna $162 5110%
Networks By Design - All Plans $162 5110%
Comm Care Network(Ccn)-All Plans $173 5457%
Great West-One Health Plan Ppo/Pos-All Plans $173 5457%
Phcs/Multiplan/Beech St-All Plans $173 5457%
Interplan-All Plans $179 5647%
Bps-All Plans $183 5773%
Ppo Alliance-All Plans $183 5773%
Pref Health Networl(Phn)-All Plans $183 5773%
Scan Mcare-All Plans $203 6404%
St Joseph Heritage Hltcare Mcr Adv $203 6404%
Correct Care Integ Health-All Plans $244 7697%
Employer Direct Healthcare-All Plans $244 7697%
Creative Legal Services-All Plans $264 8328%
Canopy Op Only $365 11514%
Vnpn - All Plans $365 11514%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals