CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Mc Donough District Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $24
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 7.57x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Mc Donough District Hospital is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 7.57x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $20 (631%)
Insurance Median: $24 (757%)
Cash: $20 (631% of Medicare)
Ins. Median: $24 (757% 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 757% of the Medicare baseline (a markup of 657%). 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
Health Alliance $2 - $26 63%
Aetna $3 - $29 95%
Blue Cross Blue Shield $3 - $29 95%
Hfn $3 - $26 95%
Humana $3 - $26 95%
Medicaid / KanCare $3 - $29 95%
Medicare (plans) $3 95%
Meridian $3 95%
Molina $3 - $29 95%
Mutual Medical $3 - $29 95%
Tricare $3 95%
UnitedHealthcare $3 - $26 95%
Veteran Affairs $3 95%
Springfield Health $24 757%
Consociate $25 789%
Trilogy $25 789%
Blue Choice $26 820%
Current Health $26 820%
Healthlink $26 - $27 820%
Preferred Plan $28 883%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals