CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: John Muir Medical Center - Walnut Creek Campus

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $218
  • Cash Discount Price: $181
  • vs. Medicare Baseline: 68.77x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at John Muir Medical Center - Walnut Creek Campus is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $181. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 68.77x the Medicare baseline. Located in 1601 Ygnacio Valley Rd, Walnut Creek, CA.
Cash / Self-Pay
$181

Average discount available for prompt cash payment at this facility.

Insurance Median
$218

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: $181 (5710%)
Insurance Median: $218 (6877%)
Cash: $181 (5710% of Medicare)
Ins. Median: $218 (6877% 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 6877% of the Medicare baseline (a markup of 6777%). 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 - $322 95%
Alignment Health [1177113] $3 95%
Blue Cross Blue Shield $3 - $290 95%
Blue Shield-Network Mcare [1006127] $3 95%
Care 1St Health Plan [1094113] $3 95%
Caremore [1171113] $3 95%
Contra Costa County Jail [1012104] $3 95%
Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] $3 95%
Easy Choice Health Plan [1083113] $3 95%
Essence Healthcare [1049028] $3 95%
Essence Healthcare [1049128] $3 95%
Golden State-Network Mcare [1023127] $3 95%
Health Net-Network Mcare [1028127] $3 95%
Hospice Of East Bay [1085104] $3 95%
Humana $3 - $370 95%
Medicare (plans) $3 - $357 95%
Scan-Network Mcare [1043127] $3 95%
UnitedHealthcare $3 - $261 95%
Veterans Administration [1051113] $3 95%
Generic Commercial/Indemnity [1017001] $4 - $178 126%
Generic Hmo [1018103] $4 126%
Generic Ppo [1021104] $4 126%
Jmpn Canopy Hn [1640000011] $4 126%
Canopy Hn Hmo [1166103] $6 189%
Brms [1091104] $41 1293%
Delta Health Systems [1032104] $41 1293%
Empire Plan [1092104] $41 1293%
Healthcomp [1089104] $41 - $379 1293%
Carecentrix [1011001] $143 - $178 4511%
Aps Healthcare [1003103] $160 - $201 5047%
United Behavioral Health [1048103] $179 - $224 5647%
Cigna $181 - $319 5710%
Carelon Behavioral Health [1050104] $196 - $245 6183%
Fortified Provider Network [1063104] $196 - $245 6183%
Medigap [1036001] $196 - $245 6183%
Three Rivers Provider Network [1073104] $196 - $245 6183%
Health Net Hmo [1028103] $203 - $254 6404%
Health Net-Network [1028026] $203 - $254 6404%
Contra Costa Health Plan Hmo [1013103] $214 - $268 6751%
Blue Shield Hmo [1006103] $221 - $283 6972%
Blue Shield-Network [1006026] $221 - $283 6972%
Blue Shield Ppo [1006104] $237 - $328 7476%
Western Health Advantage Hmo [1053103] $250 - $357 7886%
Health Net Ppo [1028104] $259 - $324 8170%
Federal Correction Institute [1062104] $285 - $357 8991%
First Health [1016104] $285 - $379 8991%
Healthsmart - Pka Interplan [1031104] $285 - $357 8991%
National Provider Network/Plancare America [1069104] $285 - $357 8991%
Networks By Design [1084104] $285 - $357 8991%
Pponext [1072104] $285 - $357 8991%
Sutter Preferred Health Plan [1044104] $285 - $357 8991%
Kaiser Hmo [1033103] $289 - $361 9117%
Health Management Network [1066104] $303 - $379 9558%
Galaxy Health Network [1064104] $321 - $401 10126%
Integrated Health Plan [1075104] $321 - $401 10126%
Donor Network West [1008103] $4,000 126183%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1601 Ygnacio Valley Rd, Walnut Creek, CA 94598
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals