CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Waverly Health Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $35
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 11.04x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Waverly Health Center is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 11.04x the Medicare baseline. Located in 312 9Th Street Sw, Waverly, IA.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $30 (946%)
Insurance Median: $35 (1104%)
Cash: $30 (946% of Medicare)
Ins. Median: $35 (1104% 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 1104% of the Medicare baseline (a markup of 1004%). 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
Choicecare Network - All Plans $22 694%
UnitedHealthcare $22 - $41 694%
Medicare (plans) $25 789%
Midlands Choice Mcare $25 789%
Wellmark Hmo $26 820%
Wellmark Ppo - All Other Plans $29 915%
Hlth Partners Bridges Ntwrk $40 1262%
Hlth Partners Open Ntwrk - All Other Plans $40 1262%
Aetna $49 1546%
Health Alliance-All Plans $52 1640%
Midlands Choice-All Other Plans $52 1640%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 312 9Th Street Sw, Waverly, IA 50677
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals