CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Hamilton Memorial Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $24
  • Cash Discount Price: $26
  • vs. Medicare Baseline: 7.57x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Hamilton Memorial Hospital is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 7.57x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$26

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: $26 (820%)
Insurance Median: $24 (757%)
Cash: $26 (820% 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
Medicaid / KanCare $11 - $12 347%
Aetna $12 - $27 379%
Blue Cross Blue Shield $12 - $28 379%
Health Alliance $12 - $24 379%
Humana $12 379%
Medicare (plans) $12 379%
UnitedHealthcare $12 - $22 379%
Wellcare $12 379%
Alliance Coal $21 662%
Healthscope $21 662%
Wellfirst (Ssmhic) $21 662%
Hope Trust $23 726%
Cigna $24 757%
Hfn, Inc $24 - $27 757%
Healthlink $26 - $27 820%
Multiplan $26 820%
Siho $27 852%
Three Rivers Provider $27 852%
Healthsmart $29 915%
Stratose $29 915%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals