CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Adventist Health Vallejo

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $3
Cash Discount Price: $40
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Adventist Health Vallejo is $3. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 0.95x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $40 (1262%)

Insurance Median: $3 (95%)

Cash: $40 (1262% of Medicare)

Ins. Median: $3 (95% 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.

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
Blue Shield Behav Hlth	$1 - $120	32%
Blue Shield Epn	$1 - $126	32%
Blue Shield Non-Epn-All Other Plans	$1 - $124	32%
UnitedHealthcare	$1 - $170	32%
Western Growers-All Plans	$1 - $142	32%
Beech Street-All Plans	$2 - $200	63%
Choicecare-All Plans	$2 - $187	63%
Cigna	$2 - $214	63%
Galaxy Network-All Plans	$2 - $240	63%
Health Management Network-All Plans	$2 - $227	63%
Interplan-All Plans	$2 - $174	63%
Kaiser-All Plans	$2 - $224	63%
Phcs-All Plans	$2 - $147	63%
Three Rivers-All Plans	$2 - $240	63%
Blue Shield Mcr Adv	$3	95%
Medi-Cal	$3 - $4	95%
Medicare (plans)	$3	95%
Napa County Mcal Child	$3	95%
Tricare	$3	95%
Va Mcr-All Other Plans	$3	95%
Va Medi-Cal	$3 - $4	95%
Ah Employee Health Plan-All Plans	$6	189%
Healthnet-All Plans	$8	252%
Aetna	$19	599%
Blue Cross Blue Shield	$29 - $35	915%

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 $40.
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 Vallejo 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.