CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Adventist Health Howard Memorial

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $63
Cash Discount Price: $31
vs. Medicare Baseline: 19.87x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Adventist Health Howard Memorial is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 19.87x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$31

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $31 (978%)

Insurance Median: $63 (1987%)

Cash: $31 (978% of Medicare)

Ins. Median: $63 (1987% 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 1987% of the Medicare baseline (a markup of 1887%). 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
Medi-Cal	$4	126%
Blue Shield Mcare	$16 - $25	505%
Medicare (plans)	$16 - $26	505%
Tricare	$16 - $25	505%
UnitedHealthcare	$18 - $98	568%
Blue Cross Blue Shield	$30 - $36	946%
Ah Employee Health Plan - All Plans	$42 - $66	1325%
Aetna	$54 - $85	1703%
Blue Shield - All Other Plans	$55 - $87	1735%
Blue Shield Epn	$55 - $87	1735%
Western Growers/Pinnacle - All Plans	$61 - $95	1924%
First Health Ppo - All Plans	$65 - $102	2050%
Ghn Ppo - All Plans	$65 - $102	2050%
Healthnet - All Plans	$66 - $104	2082%
Brms - All Plans	$69 - $108	2177%
Cigna	$69 - $108	2177%

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 $31.
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 Howard Memorial 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.