CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Loma Linda University Children's Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $15
Cash Discount Price: $38
vs. Medicare Baseline: 4.73x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Loma Linda University Children's Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 4.73x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $38 (1199%)

Insurance Median: $15 (473%)

Cash: $38 (1199% of Medicare)

Ins. Median: $15 (473% 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 473% of the Medicare baseline (a markup of 373%). 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
Alpha Care Medical Group	$3 - $5	95%
Dignity Health	$3 - $5	95%
Epic Health Plan	$3 - $54	95%
Inland Empire Health Plan (Iehp)	$3 - $5	95%
Kaiser Foundation Hospitals	$3 - $90	95%
UnitedHealthcare	$3	95%
Upland Medical Group	$3	95%
Vantage Medical Group	$3 - $5	95%
Molina Healthcare Of Ca	$4	126%
Heritage Provider Network	$5	158%
Adventist Health	$7 - $27	221%
Lluh Dept Of Risk Management	$8 - $32	252%
Blue Shield Of California	$15 - $22	473%
Global Benefits Group	$20 - $81	631%
Temecula Valley Physicians Medical Group	$20	631%
Trivalley Medical Group	$20	631%
Cigna	$21 - $24	662%
Networks By Design	$21 - $88	662%
Aetna	$22	694%
Multiplan	$26 - $108	820%
Galaxy Health	$28 - $115	883%
Prime Health Services	$28 - $115	883%
Blue Cross Blue Shield	$30	946%

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 $38.
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 Loma Linda University Children's Hospital 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.