CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Good Samaritan Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $4
  • Cash Discount Price: $1,073
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Good Samaritan Hospital is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,073. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 1.26x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.
Cash / Self-Pay
$1,073

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

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: $1,073 (33849%)
Insurance Median: $4 (126%)
Cash: $1,073 (33849% of Medicare)
Ins. Median: $4 (126% 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.

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 - $16 95%
Affinity Medical Group $3 95%
Alignment Health Plan $3 95%
Blue Cross Blue Shield $3 - $17 95%
Blue Shield $3 - $6 95%
Care1St Health Plan $3 95%
Central Health Plan $3 95%
Clever Care Of Golden State $3 95%
Easy Choice Health Plan $3 95%
Humana $3 - $751 95%
Managed Health Network $3 95%
On Lok Senior Health $3 95%
Palo Alto Medical $3 - $4 95%
Santa Clara Family Health Plan $3 - $204 95%
Scan Health Plan $3 95%
Triwest Healthcare Alliance $3 95%
United $3 - $274 95%
University Healthcare $3 95%
Vitality Health Plan $3 95%
Affinity Medical Group Comm $4 126%
Corvel Corporation $4 126%
Health Net $4 - $250 126%
Physicians Medical Group $4 126%
Bright Health $6 189%
Canopy $6 189%
Cigna $33 - $858 1041%
Medcare Partners $161 5079%
Nx Health Network $644 20315%
Sutter Select $644 20315%
Multiplan $698 - $858 22019%
First Health $816 - $1,073 25741%
Healthsmart $858 27066%
Intercontinental Corporation $858 27066%
Pha Pacific Health Alliance $858 27066%
Ppo Next $858 27066%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2425 Samaritan Drive, San Jose, CA 95124
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals