CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Fishermen's Community Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $142
  • Cash Discount Price: $163
  • vs. Medicare Baseline: 44.79x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Fishermen's Community Hospital is $142. 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 44.79x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.
Cash / Self-Pay
$163

Average discount available for prompt cash payment at this facility.

Insurance Median
$142

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: $142 (4479%)
Cash: $163 (5142% of Medicare)
Ins. Median: $142 (4479% 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 4479% of the Medicare baseline (a markup of 4379%). 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%
UnitedHealthcare $1 - $251 32%
Aetna $2 - $192 63%
Sunshine State $2 63%
Vista $2 63%
Wellcare $2 63%
Blue Cross Blue Shield $42 - $251 1325%
Leon Medical $53 1672%
Medica Health Plan $53 1672%
Medicare (plans) $53 - $71 1672%
Humana $57 1798%
Avmed $58 - $208 1830%
Cigna $60 - $201 1893%
Non Contracted $92 2902%
International $163 5142%
Amerihealth $188 5931%
Dimension Health Plan $188 - $226 5931%
Affordable $226 7129%
Phcs $226 7129%
Quality Health $226 7129%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3301 Overseas Hwy, Marathon, FL 33050
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals