CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Seneca District Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $7
  • Cash Discount Price: $41
  • vs. Medicare Baseline: 2.21x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Seneca District Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 2.21x the Medicare baseline. Located in 130 Brentwood Drive, Chester, CA.
Cash / Self-Pay
$41

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: $41 (1293%)
Insurance Median: $7 (221%)
Cash: $41 (1293% 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
UnitedHealthcare $2 - $94 63%
Ambetter / Centene $4 126%
Amthem Bc Mcal $4 126%
Medi-Cal $4 126%
Partnership Hp-All Plans $4 126%
Blue Cross Blue Shield $5 - $86 158%
Imperial Hp Ma-All Plans $5 - $76 158%
Tricare $5 - $67 158%
Alliance- All Plans $6 - $93 189%
Beech Street Corp- All Plans $6 - $91 189%
Blue Shield Ipf/Ca Exchange $6 - $86 189%
Blue Shield Of Ca- All Other Plans $6 - $95 189%
Cigna $6 - $91 189%
Community Care Network - All Plans $6 - $93 189%
Coventry- All Plans $6 - $94 189%
Healthnet - All Other Plans $6 - $95 189%
Integrated Hp-All Plans $6 - $91 189%
Interplan Corp- All Plans $6 - $91 189%
Medincrease- All Plans $6 - $91 189%
Multiplan- All Plans $6 - $91 189%
Northern Nevada Health Network- All Plans $6 - $94 189%
Pacificare - All Plans $6 - $91 189%
Provider Ntwrk Of America-All Plans $6 - $91 189%
Superior California Ppo - All Plans $6 - $94 189%
Three Rivers- All Plans $6 - $95 189%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 Brentwood Drive, Chester, CA 96020
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals