CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Medstar Health Physical Therapy

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $49
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 15.46x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Medstar Health Physical Therapy is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 15.46x the Medicare baseline. Located in 102 Irving St Nw, Washington, DC.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $49 (1546%)
Insurance Median: $49 (1546%)
Cash: $49 (1546% of Medicare)
Ins. Median: $49 (1546% 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 1546% of the Medicare baseline (a markup of 1446%). 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
Aetna $3 - $53 95%
Carefirst Advantage Inc $3 95%
Health Care Service Corporation $3 95%
Humana $3 95%
Kaiser Permanente $3 - $53 95%
Tricare $3 95%
UnitedHealthcare $3 - $61 95%
Carefirst Blue Choice Inc $37 - $49 1167%
Jhhc $49 1546%
Pfc $49 1546%
Medstar Family Choice Inc $54 1703%
Kaiser $59 1861%
Cigna $65 2050%
First Health $65 2050%
Private Healthcare Systems (Phcs) $65 2050%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 Irving St Nw, Washington, DC 20010
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL