CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Veterans Memorial Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $28
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 8.83x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Veterans Memorial Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 8.83x the Medicare baseline. Located in 40 1St Street Se, Waukon, IA.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $36 (1136%)
Insurance Median: $28 (883%)
Cash: $36 (1136% of Medicare)
Ins. Median: $28 (883% 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 883% of the Medicare baseline (a markup of 783%). 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 Mcaid - All Other Plans $3 95%
Wellmark Hmo - All Other Plans $3 95%
Wellmark Ppo $3 95%
Amerigroup Mcr Adv $28 883%
Humana $28 - $48 883%
Iowa Total Care Exchange $28 883%
Iowa Total Care Mcr Adv $28 883%
Medica Mcr Adv $28 883%
Molina Mcr Adv $28 883%
Quartz Mcr Adv $28 883%
UnitedHealthcare $28 - $54 883%
Welmark Mcr Adv $28 883%
Iowa Total Care Mcaid - All Other Plans $33 1041%
Molina Mcaid - All Other Plans $33 1041%
Quartz Comm - All Other Plans $48 1514%
Medica Comm - All Other Plans $51 1609%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 40 1St Street Se, Waukon, IA 52172
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals