CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $113
  • Cash Discount Price: $202
  • vs. Medicare Baseline: 35.65x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Nemours Children's Hospital, Delaware is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 35.65x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$202

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $202 (6372%)
Insurance Median: $113 (3565%)
Cash: $202 (6372% of Medicare)
Ins. Median: $113 (3565% 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 3565% of the Medicare baseline (a markup of 3465%). 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
Priority Partners John Hopkins $3 - $99 95%
Tricare $3 95%
Us Family Health Plan $4 126%
Celtic Transplant $5 - $202 158%
Keystone First Hlth Plan $40 - $89 1262%
Amerihealth Caritas Delaware $62 - $115 1956%
Blue Cross Blue Shield $63 - $178 1987%
Celtic Transplant For De First Health $71 2240%
Delaware First Health $73 2303%
UnitedHealthcare $74 - $126 2334%
Wellpoint Maryland $75 2366%
Kidz Partners $76 2397%
Health Partners $78 2461%
Upmc $80 2524%
Fidelis $81 2555%
Aetna $86 - $117 2713%
Six Degrees Health Transplant $101 3186%
Cigna $111 - $127 3502%
Great West-One Health Plan $111 - $127 3502%
Ambetter / Centene $115 3628%
Geisinger Health Plan $121 3817%
Integra Administrative Group $121 3817%
National Transplant Network (Ntn) $131 4132%
Six Degrees Health $131 4132%
Star Healthcare Network $131 4132%
Life Trac Solid Organ And Bmt Transplant $141 4448%
First Health Network $192 6057%
Insurance Administrators Of America $192 6057%
Interlink Transplant Network $192 6057%
Multiplan $192 6057%
Preferred Healthcare $192 6057%
Private Healthcare Systems $192 6057%
Three Rivers Provider Network $192 6057%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens