CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Northside Hospital Cherokee

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $110
  • Cash Discount Price: $150
  • vs. Medicare Baseline: 34.70x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Northside Hospital Cherokee is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 34.70x the Medicare baseline. Located in 450 Northside Cherokee Boulevard, Canton, GA.
Cash / Self-Pay
$150

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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: $150 (4732%)
Insurance Median: $110 (3470%)
Cash: $150 (4732% of Medicare)
Ins. Median: $110 (3470% 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 3470% of the Medicare baseline (a markup of 3370%). 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
Fairly Group $2 63%
Aetna $3 - $40 95%
Bccp $3 95%
Blue Cross Blue Shield $3 - $139 95%
Caresource $3 - $74 95%
Cbww $3 95%
Champus Va $3 95%
Clear Springs Eon Health $3 95%
Clover Health $3 95%
Coventry $3 - $136 95%
Humana $3 95%
Kaiser $3 - $174 95%
Medicaid / KanCare $3 - $4 95%
Medicare (plans) $3 - $4 95%
Pruitt Health Premier $3 95%
Tricare $3 95%
UnitedHealthcare $3 - $32 95%
Va Ccn $3 95%
Wellcare $3 95%
Ambetter / Centene $4 - $38 126%
Amerigroup $4 - $30 126%
Us Dept Of Labor Wc $4 126%
Corvel Workers Comp $5 158%
Employers Choice Network $5 158%
Georgia Workers Compensation $5 158%
Oscar $5 158%
Streamline Imaging $5 158%
Cigna $30 - $126 946%
Northside Health Network $60 1893%
Georgia Reproductive Specialists $80 2524%
Medlien Healthcare Services $80 2524%
Med Care Solutions $90 2839%
Health One Alliance_Ppo $110 3470%
Quick Trip $110 3470%
Novanet_Ppo $140 4416%
Phcs $150 4732%
Beech Steet $170 5363%
Multiplan $170 5363%
Multiplan Workers Comp $170 5363%
Careiq $200 6309%
Cherokee County Board Of Health $200 6309%
Dekalb_Department Of Health $200 6309%
Fifa $200 6309%
Institutional Marietta Surgery Center $200 6309%
Institutional Veterans Evaluation Services $200 6309%
Rabun County Boc $200 6309%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 450 Northside Cherokee Boulevard, Canton, GA 30115
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals