CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Portneuf Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $98
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 30.91x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Portneuf Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 30.91x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $69 (2177%)
Insurance Median: $98 (3091%)
Cash: $69 (2177% of Medicare)
Ins. Median: $98 (3091% 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 3091% of the Medicare baseline (a markup of 2991%). 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
Aetna $24 - $98 757%
Healthscope Benefits [2290] $24 757%
UnitedHealthcare $24 - $104 757%
Black Lung [6055] $47 1483%
Employee Benefit Management Services [2445] $47 - $69 1483%
Healthcare Highways [2210] $47 - $109 1483%
Lucent Health [6000] $47 1483%
Moda Health [6100] $47 1483%
Oncology Patient Assistance Programs [2295] $47 1483%
Pending Ssi [1616] $47 1483%
Web Tpa [2115] $47 1483%
Pacific Source Health Plans [2850] $66 2082%
Liberty Health Share Lhs/Medcost Solutions Llc [2400] $69 2177%
Medishare Christian Care [1645] $69 2177%
Multiplan [1680] $77 - $109 2429%
Worker'S Comp [2125] $84 - $86 2650%
Cigna $85 2681%
Enablecomp [1350] $86 2713%
Transamerican Life [1990] $86 2713%
First Health [1375] $95 2997%
Mailhandlers [1595] $98 3091%
Selecthealth [3740] $98 - $104 3091%
Geha [1415] $104 3281%
Humana $104 3281%
Administrative Concepts [1005] $109 3438%
Healthfirst [2395] $109 3438%
Healthnet [1495] $109 3438%
Hometown Health [2155] $109 3438%
Mayo Clinic Health Solutions [2280] $109 3438%
Meritain Health [1655] $109 3438%
Mutual Of Omaha [1685] $109 3438%
National Association Of Letter Carriers [1695] $109 3438%
New Era Life Insurance Company [1705] $109 3438%
Pan American Life Insurance Co [1770] $109 3438%
Pba [1775] $109 3438%
Phcs [1780] $109 3438%
Planned Administrators Inc [2360] $109 3438%
Trustmark [2030] $109 3438%
Ut Id Teamsters [3760] $109 3438%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hospital Way, Pocatello, ID 83201
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals