CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Mt Sinai Hospital Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $18
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 5.68x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Mt Sinai Hospital Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 5.68x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $46 (1451%)
Insurance Median: $18 (568%)
Cash: $46 (1451% of Medicare)
Ins. Median: $18 (568% 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 568% of the Medicare baseline (a markup of 468%). 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
Advocate Physician Prtnrs - All Other Plans $3 95%
Advocate Physician Prtnrs Mcr $3 95%
Ambetter / Centene $3 - $106 95%
Blue Cross Blue Shield $3 - $64 95%
Cenpatico Illinicare Dual $3 95%
Cenpatico Illinicare Mcr - All Other Plans $3 95%
Cigna $3 - $125 95%
Harmony Behavioral Htlh - All Plans $3 95%
Humana $3 - $316 95%
Lawndale Christian - All Plans $3 - $20 95%
Meridian/Harmony D-Snp - All Plans $3 95%
Molina Mcr - All Other Plans $3 95%
Nextlevel Hlth Icp Fhp Aca - All Plans $3 95%
Oscar - All Plans $3 - $35 95%
Tricare $3 95%
UnitedHealthcare $3 95%
Va Healthnet - All Plans $3 95%
Zing Mcr Adv - All Plans $3 95%
Aetna $4 - $228 126%
Family Health Network Mcaid - All Plans $4 126%
Molina Mcaid $4 126%
Partners In Hlth - All Plans $13 - $40 410%
Healthlink Hmo $16 - $50 505%
Healthlink Ppo - All Other Plans $16 - $50 505%
Compsych Ip/Op Only - All Plans $19 - $60 599%
Hfn Platinum $21 - $65 662%
Multiplan Primary Ntwrk/Phcs - All Other Plans $22 - $71 694%
Hfn Epo $25 - $81 789%
Multiplan Complementary Ntwrk $25 - $81 789%
Hfn Ppo - All Other Plans $28 - $89 883%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals