CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Doctors Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $95
  • Cash Discount Price: $163
  • vs. Medicare Baseline: 29.97x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Doctors Hospital is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 29.97x the Medicare baseline. Located in 5000 University Dr, Coral Gables, FL.
Cash / Self-Pay
$163

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $163 (5142%)
Insurance Median: $95 (2997%)
Cash: $163 (5142% of Medicare)
Ins. Median: $95 (2997% 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 2997% of the Medicare baseline (a markup of 2897%). 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
Amerigroup $1 32%
Medicaid / KanCare $1 - $2 32%
Aetna $2 - $201 63%
Sunshine State $2 63%
UnitedHealthcare $2 - $251 63%
Vista $2 63%
Wellcare $2 63%
Avmed $3 - $124 95%
Blue Cross Blue Shield $3 - $163 95%
Humana $3 95%
Medica Health Plan $3 95%
Medicare (plans) $3 - $4 95%
Cigna $4 - $201 126%
Leon Medical $4 126%
Non Contracted $92 2902%
Amerihealth $113 3565%
International $163 5142%
Dimension Health Plan $188 - $226 5931%
Affordable $213 6719%
Phcs $226 7129%
Quality Health $226 7129%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5000 University Dr, Coral Gables, FL 33146
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals