CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Rochelle Community Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $96
Cash Discount Price: $128
vs. Medicare Baseline: 30.28x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Rochelle Community Hospital is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 30.28x the Medicare baseline. Located in 900 N 2Nd St, Rochelle, IL.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $128 (4038%)

Insurance Median: $96 (3028%)

Cash: $128 (4038% of Medicare)

Ins. Median: $96 (3028% 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 3028% of the Medicare baseline (a markup of 2928%). 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	$4 - $45	126%
Blue Cross Blue Shield	$4 - $128	126%
Medicaid / KanCare	$4	126%
The Alliance-All Plans	$4	126%
Health Alliance Mcr Adv	$45	1420%
Humana	$45 - $102	1420%
UnitedHealthcare	$45 - $115	1420%
Va Ccn - All Plans	$45	1420%
Wellcare Mcr Adv - All Plans	$46	1451%
Cigna	$96	3028%
Osf Dan Ppo - All Plans	$96	3028%
Beech Street-All Plans	$102	3218%
First Health - All Plans	$102	3218%
Health Alliance-All Other Plans	$102	3218%
Ecoh-All Plans	$109	3438%
Hfn-All Plans	$109	3438%
Quartz Health Solutions-All Plans	$113	3565%
Multiplan-All Plans	$120	3785%

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 $128.
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 Rochelle 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.