CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Saint Agnes Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $24
  • Cash Discount Price: $265
  • vs. Medicare Baseline: 7.57x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Saint Agnes Medical Center is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 7.57x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$265

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $265 (8360%)
Insurance Median: $24 (757%)
Cash: $265 (8360% of Medicare)
Ins. Median: $24 (757% 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 757% of the Medicare baseline (a markup of 657%). 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.

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 $3 - $74 95%
Blue Cross Blue Shield $3 - $157 95%
Humana $3 - $78 95%
Medicare (plans) $3 - $78 95%
UnitedHealthcare $3 - $76 95%
Welbe Health $3 - $78 95%
Align Senior Care $4 - $87 126%
Correctcare Integrated Health $4 126%
Medi-Cal Healthnet $4 - $5 126%
Geha $5 158%
Kaiser Permanente $6 - $133 189%
Advantek Central Usd $8 - $157 252%
Blue Shield - Ca $9 - $30 284%
Meritain $18 568%
Trustmark Small Business Benefits $18 568%
Allied Benefit Systems $19 599%
Boon Chapman $19 599%
Hap $19 599%
Webtpa $19 599%
Blue Benefit Administrators Of Massachusetts $30 946%
Blue Care Network $30 946%
Blue Distinction Transplant $30 946%
Blue Shield - Id (Regence) $30 946%
Blue Shield - Ny Highmark Northeastern $30 946%
Blue Shield - Ny Highmark Western $30 946%
Blue Shield - Pa (Highmark) $30 946%
Blue Shield - Wa (Regence) $30 946%
St Agnes Nicu Valley Childrens Hospital $35 1104%
Coventry $37 1167%
Healthnet $37 - $44 1167%
Cba Network By Design $40 1262%
Network Health $40 1262%
Allegiance $42 1325%
American Postal Workers Secondary $42 1325%
Cigna $42 1325%
Multiplan $45 1420%
Phcs $45 1420%
Interplan $49 1546%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals