CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $175
Cash Discount Price: $256
vs. Medicare Baseline: 55.21x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Children's Healthcare of Atlanta at Scottish Rite is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $256. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 55.21x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$256

Average discount available for prompt cash payment at this facility.

Insurance Median

$175

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: $256 (8076%)

Insurance Median: $175 (5521%)

Cash: $256 (8076% of Medicare)

Ins. Median: $175 (5521% 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 5521% of the Medicare baseline (a markup of 5421%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Caresource [61]	$4	126%
Peachstate [43]	$4	126%
Amerigroup [102]	$5	158%
Cigna	$169	5331%
Blue Cross Blue Shield	$170 - $250	5363%
United [5]	$170	5363%
Ambetter / Centene	$171	5394%
Aetna	$172	5426%
Oscar [228]	$172	5426%
Caresource Marketplace Bronze/Silver/Gold [60]	$174	5489%
Kaiser [6]	$174	5489%
Sidecar Health [236]	$177	5584%
Direct Employer Agreements [72]	$179 - $218	5647%
Coventry [9]	$180	5678%
First Health [74]	$192	6057%
Northeast Georgia Heatlh System [808]	$192	6057%
Veracity Benefits [809]	$192	6057%
Phcs [93]	$218	6877%
Secure Health [340]	$218	6877%
Beech Street [71]	$230	7256%
Multiplan [92]	$251	7918%
Novanet [41]	$256	8076%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $256.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 81001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Children's Healthcare of Atlanta at Scottish Rite is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 81001.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.