CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $74
  • Cash Discount Price: $181
  • vs. Medicare Baseline: 23.34x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Nemours Childrens Hospital, Florida is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $181. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 23.34x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.
Cash / Self-Pay
$181

Average discount available for prompt cash payment at this facility.

Insurance Median
$74

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: $181 (5710%)
Insurance Median: $74 (2334%)
Cash: $181 (5710% of Medicare)
Ins. Median: $74 (2334% 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 2334% of the Medicare baseline (a markup of 2234%). 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
Tricare $3 95%
UnitedHealthcare $3 95%
Cigna $4 - $73 126%
Truli $17 - $72 536%
Florida Blue $18 - $110 568%
Avmed $56 1767%
Employers Health Network Fl $72 2271%
Aetna $80 2524%
Evolutions Healthcare $81 2555%
Integra Administrative Group $109 3438%
Global Medical Management $118 3722%
Prime Health Services $118 3722%
Star Healthcare Network $118 3722%
Velocity $136 4290%
First Health Network $141 4448%
Pnoa $145 4574%
Seminole Tribe Of Fl $145 4574%
Private Healthcare Systems $167 5268%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6535 Nemours Pkwy, Orlando, FL 32827
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens