CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Adventist Health Tulare

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $7
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 2.21x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Adventist Health Tulare is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 2.21x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.
Cash / Self-Pay
$19

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $19 (599%)
Insurance Median: $7 (221%)
Cash: $19 (599% of Medicare)
Ins. Median: $7 (221% 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 221% of the Medicare baseline (a markup of 121%). 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
Blue Cross Blue Shield $1 - $31 32%
Blue Shield-All Other Plans $1 - $191 32%
Cigna $1 - $202 32%
Western Growers - All Plans $1 - $201 32%
Hs Interplan-All Plans $2 - $293 63%
Multiplan - All Plans $2 - $371 63%
Network By Design-All Plans $2 - $284 63%
UnitedHealthcare $2 - $317 63%
Blue Shield Mcare $3 95%
Ccipa Medi-Cal - All Plans $3 - $5 95%
Dignity Mcal Op Only $3 - $4 95%
Dignity Mcr Op Only - All Other Plans $3 95%
Fhcn Pace Mcr Adv - All Plans $3 95%
Healthnet Medi-Cal $3 - $5 95%
Independence Op Only - All Plans $3 - $4 95%
Medi-Cal $3 - $4 95%
Medicare (plans) $3 95%
Prime Health - All Plans $3 95%
Tricare $3 95%
Cal Forensic Med Grp - All Plans $4 126%
Prison Hlthcre - All Plans $4 126%
Bright Health - All Plans $5 158%
Ah Employee Health Plan - All Plans $6 189%
Incentive Hlth - All Plans $6 189%
Blue Shield Epn $8 - $138 252%
Healthnet Hmo/Ppo - All Other Plans $8 252%
Aetna $27 852%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 869 North Cherry Street, Tulare, CA 93274
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals