CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Coalinga Regional Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $26
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 8.20x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Coalinga Regional Medical Center is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 8.20x the Medicare baseline. Located in 1191 Phelps Avenue, Coalinga, CA.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $79 (2492%)
Insurance Median: $26 (820%)
Cash: $79 (2492% of Medicare)
Ins. Median: $26 (820% 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 820% of the Medicare baseline (a markup of 720%). 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 $4 - $26 126%
Healthnet Mcal $4 126%
Medi-Cal $4 126%
Healthnet Hmo/Ppo - All Other Plans $5 158%
Healthnet Mcr Adv $26 820%
Department Of State Hosp - All Plans $34 1073%
Healthnet Prison $34 1073%
Cigna $93 2934%
Aetna $112 3533%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1191 Phelps Avenue, Coalinga, CA 93210
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals