CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Scripps Memorial Hospital La Jolla

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $23
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 7.26x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Scripps Memorial Hospital La Jolla is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 7.26x the Medicare baseline. Located in 9888 Genesee Avenue, La Jolla, CA.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $35 (1104%)
Insurance Median: $23 (726%)
Cash: $35 (1104% of Medicare)
Ins. Median: $23 (726% 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 726% of the Medicare baseline (a markup of 626%). 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 - $71 95%
Alignment Health Plan [443] $3 95%
Astiva Mcr Adv [464] $3 95%
Bc Mcr Adv [830] $3 95%
Blue Cross Blue Shield $3 - $37 95%
Bs Mcr Adv [829] $3 95%
Central Health Mcr Adv [441] $3 95%
Cigna $3 - $49 95%
Clever Care Mcr Adv [465] $3 95%
D-Snp Mcr Adv [889] $3 95%
Dsnp/Csnp - Generic [458] $3 95%
Family Health Centers Pace Mcr Adv Hmo [556] $3 95%
Family Health Centers Pace Medi-Cal [555] $3 95%
Gary And Mary West Pace Medi-Cal Hmo [557] $3 95%
Gpmg/Altura - Mcr Adv [888] $3 95%
Hn Mcr Adv [832] $3 95%
Humana $3 95%
Integrated Health Partners - Mcr Adv [895] $3 95%
Kaiser Northern Ca Region Mcr Adv [386] $3 95%
La Care Mcr Adv Hmo [612] $3 95%
Medicare (plans) $3 95%
Mpmg Mcr Adv [836] $3 95%
Mpmg [800] $3 95%
Ocn Mcr Adv [890] $3 95%
San Diego Pace Medi-Cal [553] $3 95%
Scan Mcr Adv [835] $3 95%
Scan [500] $3 95%
Scan [818] $3 95%
Sharp Comm Med Grp Mcr Adv [840] $3 95%
Sharp Health Plan Mcr Adv [531] $3 95%
Sharp Health Plan Mcr Adv [897] $3 95%
Sharp Rees Stealy Med Grp Mcr Adv [841] $3 95%
St Paul'S Pace Medi-Cal [551] $3 95%
Ucsd Mcr Adv [873] $3 95%
Uh Mcr Adv [831] $3 95%
Uh Palomar Health Mcr Adv [885] $3 95%
UnitedHealthcare $3 - $50 95%
Health Net [340] $5 - $48 158%
Prime Healthcare [614] $5 158%
Prospect Med Group [893] $6 189%
Radys Cpmg [803] $11 347%
Mc Alignment [917] $23 726%
Mc Blue Shield Promise Health Plan [914] $23 726%
Mc Blue Shield [902] $23 726%
Mc Health Net [904] $23 726%
Mc Scan [905] $23 726%
Mc United [906] $23 726%
Bc [814] $31 978%
Imperial County Phys Med Group [855] $31 - $48 978%
Integrated Health Partners [894] $31 978%
Perlman Med Group [899] $31 978%
Sharp Comm Med Grp [812] $31 - $64 978%
Sharp Rees Stealy Med Grp [811] $31 - $64 978%
Ucsd [807] $31 - $64 978%
Centivo [581] $33 1041%
Blue Shield [230] $47 - $51 1483%
Bs [816] $48 - $50 1514%
Hn [815] $48 1514%
Uh [819] $50 1577%
Kaiser Northern Ca Region Hmo/Ppo [384] $54 1703%
Kaiser [380] $54 1703%
Kaiser [383] $54 1703%
Rady Children'S Hospital [825] $58 1830%
Palomar Health [892] $64 2019%
Veba Med Grp [813] $64 2019%
Multi Plan Network [470] $100 3155%
First Health Network [330] $106 3344%
Pnoa [615] $106 3344%
Choice Care Network [270] $113 3565%
Healthsmart [350] $113 3565%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9888 Genesee Avenue, La Jolla, CA 92037
  • CMS Rating: ★★★★★
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals