CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Clearwater Valley Hospital & Clinics

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $15
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 4.73x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Clearwater Valley Hospital & Clinics is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 4.73x the Medicare baseline. Located in 301 Cedar Street, Orofino, ID.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $16 (505%)
Insurance Median: $15 (473%)
Cash: $16 (505% of Medicare)
Ins. Median: $15 (473% 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 473% of the Medicare baseline (a markup of 373%). 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 $11 - $20 347%
Blue Cross Blue Shield $11 - $17 347%
Humana $11 - $20 347%
Nimiipuu Mcr Adv-All Plans $11 347%
Pacific Source - All Plans $11 347%
Regence Blue Shield Mcr $11 347%
Veterans Amin-All Plans $11 347%
Corizon Correctnal Med-All Plans $15 473%
Cigna $19 599%
Idaho Phys Network-All Plans $20 631%
Multiplan / Phcs-All Plans $20 631%
First Choice-All Plans $21 662%
Geha-All Plans $21 662%
Regence Blue Shield-All Other Plans $21 662%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 301 Cedar Street, Orofino, ID 83544
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals