CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Lost Rivers Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $39
Cash Discount Price: $50
vs. Medicare Baseline: 12.30x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Lost Rivers Medical Center is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 12.30x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $50 (1577%)

Insurance Median: $39 (1230%)

Cash: $50 (1577% of Medicare)

Ins. Median: $39 (1230% 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 1230% of the Medicare baseline (a markup of 1130%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Humana	$2 - $39	63%
Regence Blue Shield-All Other Plans	$2	63%
Provider Network Of America-All Plans	$6	189%
Select Health Brightpath-All Other Plans	$35	1104%
Tricare	$35	1104%
Ihcn Brightpath-All Other Plans	$37	1167%
Va Pccc-All Plans	$38	1199%
Blue Cross Blue Shield	$39 - $62	1230%
Ihcn Brightpath Mcr Adv	$39	1230%
Molina Mcr Adv-All Plans	$39	1230%
Pacificsource Mcr Adv	$39	1230%
Regence/Brightpth Slhp Mcr	$39	1230%
Select Health Mcr Adv	$39	1230%
Prime Hlth Mcr Adv	$41	1293%
Aetna	$42 - $58	1325%
Cigna	$58	1830%
First Choice-All Plans	$58	1830%
Pacificsource Navigator-All Other Plans	$59	1861%
UnitedHealthcare	$59	1861%
Altius Health Plan-All Plans	$60	1893%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $50.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 81001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lost Rivers Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 81001.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.