CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Jefferson County Health Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $24
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 7.57x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Jefferson County Health Center is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 7.57x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $35 (1104%)
Insurance Median: $24 (757%)
Cash: $35 (1104% of Medicare)
Ins. Median: $24 (757% 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 757% of the Medicare baseline (a markup of 657%). 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
UnitedHealthcare $2 - $52 63%
Wellmark Hmo $21 662%
Tricare $22 694%
Amerigroup Mcr Adv $23 726%
Humana $23 726%
Iowa Total Care Comm - All Other Plans $23 726%
Iowa Total Care Mcr $23 726%
Molina Mcr Adv $23 726%
Iowa Total Care Mcaid $24 757%
Molina Mcaid/Chip $24 757%
Wellmark Indemnity/Ppo - All Other Plans $24 757%
Medicaid / KanCare $25 789%
Aetna $28 - $52 883%
Medicare (plans) $28 883%
Midlands New Product $48 1514%
Coventry Commercial Hmo $49 1546%
Coventry Commercial Ppo - All Other Plans $52 1640%
Midlands Choice-All Other Plans $52 1640%
Molina Marketplace - All Other Plans $58 1830%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals