CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Adventist Health Twin Cities

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $92
Cash Discount Price: $9
vs. Medicare Baseline: 29.02x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Adventist Health Twin Cities is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 29.02x the Medicare baseline. Located in 1100 Las Tablas Rd, Templeton, CA.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $9 (284%)

Insurance Median: $92 (2902%)

Cash: $9 (284% of Medicare)

Ins. Median: $92 (2902% 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 2902% of the Medicare baseline (a markup of 2802%). 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
Aetna	$3	95%
Cencal Mcr Adv - All Other Plans	$3	95%
Tricare	$3	95%
UnitedHealthcare	$3 - $197	95%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$4	126%
Ah Employee Health Plan - All Plans	$6	189%
Blue Shield Hmo/Pos	$51	1609%
Blue Shield Epo/Ppo - All Other Plans	$60	1893%
Chn-Community Hlth Ntwrk-All Plans	$68	2145%
Nbd-Ntwrks By Design Non-Exlus	$72	2271%
Pacific Health Alliance-All Plans	$112	3533%
Medi-Cal	$124	3912%
Cencal Mcal	$141	4448%
Ccah-Centrl Ca Allince Mcal-All Plans	$161	5079%
Hpn-Heritage Prov Ntwrk-All Plans	$199	6278%
Blue Shield Epn	$211	6656%
Nbd-Ntwrks By Design Exlus-All Other Plans	$338	10662%
Blue Shield Promise Mcal	$704	22208%
Coalinga-All Plans	$762	24038%

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 $9.
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 Twin Cities 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.