CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Jacksonville Memorial Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $93
Cash Discount Price: $161
vs. Medicare Baseline: 29.34x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Jacksonville Memorial Hospital is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 29.34x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$161

Average discount available for prompt cash payment at this facility.

Insurance Median

$93

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: $161 (5079%)

Insurance Median: $93 (2934%)

Cash: $161 (5079% of Medicare)

Ins. Median: $93 (2934% 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 2934% of the Medicare baseline (a markup of 2834%). 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	$3 - $161	95%
Coventry	$3 - $25	95%
Health Alliance	$3 - $109	95%
Humana	$3 - $137	95%
Medicare (plans)	$3 - $25	95%
Tricare	$3 - $29	95%
UnitedHealthcare	$3 - $116	95%
Medicaid / KanCare	$5	158%
Molina Healthcare	$5	158%
Corvel/Corcare	$22 - $43	694%
Illinois Workers Compensation	$23 - $50	726%
Commercial Workers Compensation	$48	1514%
Health Alliance Mh Employee Plan	$74	2334%
Current Health Network	$89 - $121	2808%
6 Degrees Health	$97	3060%
Hope Trust	$97	3060%
Hst	$97	3060%
Cigna	$112	3533%
Aetna	$113 - $129	3565%
Healthlink	$137	4322%
Phcs/Multiplan	$145	4574%
Hfn	$153	4826%
Liability	$161	5079%

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 $161.
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 Jacksonville 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.