CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Modoc Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $68
Cash Discount Price: $78
vs. Medicare Baseline: 21.45x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Modoc Medical Center is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 21.45x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $78 (2461%)

Insurance Median: $68 (2145%)

Cash: $78 (2461% of Medicare)

Ins. Median: $68 (2145% 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 2145% of the Medicare baseline (a markup of 2045%). 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
Integrated Hp Wc	$3	95%
Multiplan Wc	$3	95%
Ntwrks By Design Wc - All Plans	$3	95%
Adv Med Mgmt - All Plans	$4	126%
Medi-Cal	$4	126%
Medi-Cal 7/1/24	$4	126%
Partnership Hp - All Plans	$4	126%
Blue Shield Mcr Adv	$42	1325%
Blue Shield Va	$42	1325%
UnitedHealthcare	$42 - $75	1325%
Healthnet Mcr Adv	$45	1420%
Tricare	$45	1420%
Blue Cross Blue Shield	$64 - $72	2019%
Blue Shield Exch	$64	2019%
Blue Shield Comm - All Other Plans	$72	2271%
Carelon - All Plans	$72	2271%
Corvel - All Plans	$74	2334%
Aetna	$75	2366%
Coventry/First Health - All Plans	$75	2366%
Galaxy Health - All Plans	$75	2366%
Healthnet Comm - All Other Plans	$75	2366%
Hmn - All Plans	$75	2366%
Integrated Hp - All Other Plans	$75	2366%
Interplan - All Plans	$75	2366%
Multiplan - All Other Plans	$75	2366%
Superior Ca Ppo - All Plans	$75	2366%

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 $78.
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 Modoc Medical Center 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.