CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Saint Joseph Regional Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $63
  • Cash Discount Price: $552
  • vs. Medicare Baseline: 19.87x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Saint Joseph Regional Medical Center is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $552. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 19.87x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$552

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $552 (17413%)
Insurance Median: $63 (1987%)
Cash: $552 (17413% of Medicare)
Ins. Median: $63 (1987% 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 1987% of the Medicare baseline (a markup of 1887%). 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
Aetna $2 - $63 63%
Blue Cross Blue Shield $2 - $220 63%
Medicaid / KanCare $2 - $32 63%
UnitedHealthcare $2 - $83 63%
County Coroner $3 - $65 95%
Managed Health Services - Indiana $3 95%
Mdwise $3 95%
Medicare (plans) $3 - $64 95%
Meridian Complete $3 - $62 95%
Pace-Trinity Health $3 - $62 95%
Provider Partners Health Plan Of Indiana $3 - $69 95%
Auxiant $5 - $134 158%
Caresource $5 - $97 158%
Physicians Health Plan Northern Indiana Health Insurance $5 - $188 158%
Siho Insurance Services $5 - $100 158%
St Joseph County Hlth Dpt $5 - $94 158%
Allied Benefit Systems $6 - $119 189%
Blue Benefit Administrators Of Massachusetts $6 - $220 189%
Blue Care Network $6 - $220 189%
Blue Distinction Transplant $6 - $220 189%
Blue Shield - Ca $6 - $220 189%
Blue Shield - Id (Regence) $6 - $220 189%
Blue Shield - Ny Highmark Northeastern $6 - $220 189%
Blue Shield - Ny Highmark Western $6 - $220 189%
Blue Shield - Pa (Highmark) $6 - $220 189%
Blue Shield - Wa (Regence) $6 - $220 189%
Key Benefit Administrator $6 - $134 189%
Custom Design Benefits $7 - $134 221%
Hospice Of Marshall County $34 1073%
Hospice Of St Joseph County $34 1073%
Plain Church Group $35 1104%
Asr Health Benefits $63 1987%
Christian Brother Services $63 1987%
Employee Benefit Management $63 1987%
Medical Mutual $63 1987%
Meritain $63 1987%
Preferred One $63 1987%
Rural Carrier Health Benefit Plan $63 1987%
Webtpa $63 1987%
Notre Dame Athletic Association $72 2271%
Wc Notre Dame $72 2271%
Luminare Health (Detroit) $74 - $78 2334%
Encore Health $77 - $81 2429%
Ameriben $78 2461%
Indiana Criminal Justice Inst $81 2555%
Western & Southern Financial Group $81 2555%
Cigna $83 2618%
Geha $83 2618%
Group Administrators $83 2618%
Health Partners $83 2618%
Healthscope $83 2618%
Mvp $83 2618%
Prairie States $83 2618%
Priority Health $83 2618%
Professional Benefit Administrators $83 2618%
Sagamore Health Network $83 - $96 2618%
Sisco Benefits $83 2618%
Student Insurance Cma $83 2618%
Unified Group Services $83 2618%
Goshen Preferred Network $100 - $112 3155%
Christian Brothers Holy Cross $104 3281%
Signature Care $104 3281%
Bankers Life Casualty $130 4101%
Bureau Of Disability $130 4101%
Wc Align Network $130 4101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals