CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Adventist Health Sierra Vista

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $6
Cash Discount Price: $1
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Adventist Health Sierra Vista is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 1.89x the Medicare baseline. Located in 1010 Murray St, San Luis Obispo, CA.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

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 (32%)

Insurance Median: $6 (189%)

Cash: $1 (32% of Medicare)

Ins. Median: $6 (189% 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.

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
Aetna	$3	95%
Cencal Mcr Adv - All Other Plans	$3	95%
Tricare	$3	95%
UnitedHealthcare	$3 - $12	95%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$4	126%
Hpn-Heritage Prov Ntwrk-All Plans	$4	126%
Blue Shield Hmo/Pos	$5	158%
Ah Employee Health Plan - All Plans	$6	189%
Nbd-Ntwrks By Design Exclus-All Other Plans	$6	189%
Cencal Mcal	$16	505%
Ccah-Centrl Ca Allince Mcal-All Plans	$18	568%
Coalinga-All Plans	$18	568%
Blue Shield Epo/Ppo-All Other Plans	$19	599%
Nbd-Ntwrks By Design Non-Exclus	$20	631%
Medi-Cal	$35	1104%
Blue Shield Promise Mcal	$42	1325%
Blue Shield Epn	$365	11514%

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 $1.
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 Sierra Vista 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.