CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Palos Community Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $78
Cash Discount Price: $72
vs. Medicare Baseline: 24.61x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Palos Community Hospital is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 24.61x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $72 (2271%)

Insurance Median: $78 (2461%)

Cash: $72 (2271% of Medicare)

Ins. Median: $78 (2461% 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 2461% of the Medicare baseline (a markup of 2361%). 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
Blue Cross Blue Shield	$13 - $121	410%
Aetna	$18 - $121	568%
Carelon Behavioral Health [159]	$42 - $60	1325%
Healthlink [125]	$42 - $121	1325%
Magellan Behavioral Hlth [136]	$50 - $73	1577%
Multiplan/Phcs [142]	$59 - $121	1861%
Compsych [112]	$63 - $91	1987%
First Health Plan [6034]	$63 - $91	1987%
Beechstreet [176]	$67 - $97	2114%
Cigna	$67 - $121	2114%
Health'S Finest Network [126]	$71 - $103	2240%
Galaxy Health Network [220]	$84 - $121	2650%
Global Excel [1712]	$84 - $121	2650%
Health Alliance [181]	$84 - $121	2650%
UnitedHealthcare	$84 - $121	2650%

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 $72.
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 Palos Community Hospital 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.