CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Adventist Health and Rideout

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $34
Cash Discount Price: $11
vs. Medicare Baseline: 10.73x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Adventist Health and Rideout is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 10.73x the Medicare baseline. Located in 726 4Th St, Marysville, CA.

Cash / Self-Pay

$11

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $11 (347%)

Insurance Median: $34 (1073%)

Cash: $11 (347% of Medicare)

Ins. Median: $34 (1073% 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 1073% of the Medicare baseline (a markup of 973%). 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
Blue Cross Blue Shield	$3 - $101	95%
Healthnet Mcal	$3 - $26	95%
Kaiser Mcr Adv	$3	95%
Tricare	$3	95%
UnitedHealthcare	$3 - $114	95%
Ca Health And Wellness- All Plans	$4	126%
Celtic Mcaid-All Plans	$4	126%
Kaiser Mcal	$4	126%
Medi-Cal	$4	126%
Partnership Hp Mcal -All Plans	$4	126%
Ah Employee Health Plan - All Plans	$6	189%
Healthnet Comm-All Other Plans	$9 - $78	284%
Aetna	$10 - $93	315%
Kaiser-All Other Plans	$11 - $100	347%
Blue Shield Uc Care Members	$12 - $105	379%
Cigna	$13 - $112	410%
First Health-All Plans	$13 - $115	410%
Interplan-All Plans	$13 - $118	410%
Phcs-All Plans	$13 - $115	410%
Blue Shield-All Other Plans	$14 - $124	442%
Multiplan-All Plans	$14 - $124	442%

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 $11.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 81001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health and Rideout is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 81001.
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.