CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Memorial Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $23
Cash Discount Price: $25
vs. Medicare Baseline: 7.26x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Memorial Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 7.26x the Medicare baseline. Located in 4500 Memorial Drive, Belleville, IL.

Cash / Self-Pay

$25

Average discount available for prompt cash payment at this facility.

Insurance Median

$23

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: $25 (789%)

Insurance Median: $23 (726%)

Cash: $25 (789% of Medicare)

Ins. Median: $23 (726% 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 726% of the Medicare baseline (a markup of 626%). 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
Aetna	$3 - $32	95%
Blue Cross Blue Shield	$3 - $37	95%
Cox Health [757]	$3	95%
Devoted Health Plan [847]	$3	95%
Essence Healthcare [221]	$3	95%
Humana	$3 - $9	95%
Medica [662]	$3	95%
UnitedHealthcare	$3 - $31	95%
Cigna	$4 - $7	126%
Healthscope Benefits [258]	$4	126%
Allied Benefits [498]	$5 - $31	158%
Coresource [497]	$5	158%
Fmh Benefit Service Inc [222]	$5	158%
Mail Handlers [495]	$5	158%
Consociate [478]	$6	189%
Sarah Bush Lincoln [636]	$6	189%
Apwu Health Plan [216]	$7	221%
Nalc Health Benefit Plan [242]	$7	221%
Priority Health [648]	$7	221%
Healthlink [225]	$20 - $32	631%
Cox Health Systems Insurance Company [220]	$23 - $27	726%
Health Alliance [224]	$23	726%
Hope Trust [806]	$24	757%
Med-Pay [480]	$27 - $32	852%
Unicare [568]	$27 - $32	852%
First Health Commercial [734]	$31	978%
Beechstreet [551]	$32	1009%
Detego Health [868]	$32	1009%
Health Systems Inc [620]	$32	1009%
Healthcare Sol Mercy [609]	$32	1009%
Multiplan Commercial [737]	$32	1009%
Multiplan [240]	$32	1009%
Phcs [244]	$32 - $34	1009%
Preferred Health Professionals [561]	$32	1009%
Hfn [563]	$34	1073%
Medica [661]	$34	1073%

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 $25.
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 Memorial 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.