CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Valley Children's Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $98
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 30.91x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Valley Children's Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 30.91x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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%)
Insurance Median: $98 (3091%)
Ins. Median: $98 (3091% 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 3091% of the Medicare baseline (a markup of 2991%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Allcare Ipa $4 126%
Central California Alliance For Health $6 189%
Dignity Ipa_Formerly Img $6 189%
Kaiser $6 - $116 189%
La Salle Ipa $6 189%
Sante Ipa $6 189%
Central Valley Medical Providers Ipa $7 - $90 221%
Community Care Ipa $7 221%
Sequoia Health Ipa $7 221%
United Physicians Network Ipa $7 221%
Univseral Healthcare Ipa $7 221%
Adventist $8 252%
Blue Cross Blue Shield $8 - $31 252%
Cencal Health $9 284%
Kern Family Health Care $9 284%
Health Net $63 - $117 1987%
Dignity Health Central Coast $89 2808%
Community Health $98 3091%
Stanislaus Partners In Health $98 3091%
Physicians Choice Medical Group $100 3155%
Health Plan Of San Joaquin $107 3375%
Fowler Packing $111 3502%
Dignity (Formerly Managed Care Systems) $113 3565%
Kern Legacy $116 3659%
Aetna $120 3785%
Blue Shield $120 - $136 3785%
First Health Formerly Coventry $132 4164%
Bakersfield Family Medical Group $134 4227%
Network By Design $139 4385%
Community Care Health Plan $143 4511%
Health Smart $143 4511%
Key Medical Ipa $143 4511%
Sutter Health $152 4795%
Multiplan $171 5394%
UnitedHealthcare $1,132 35710%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens