CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: St Joseph Health System, LLC

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $9
  • Cash Discount Price: $9
  • vs. Medicare Baseline: 2.84x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at St Joseph Health System, LLC is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 2.84x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$9

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $9 (284%)
Insurance Median: $9 (284%)
Cash: $9 (284% of Medicare)
Ins. Median: $9 (284% 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 284% of the Medicare baseline (a markup of 184%). 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.

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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 $1 - $92 32%
Amish Aid $1 - $33 32%
Blue Cross Blue Shield $1 - $49 32%
Cigna $1 - $136 32%
Lutheran Network $1 - $75 32%
Lutheran Preferred $1 - $82 32%
Php $1 - $54 32%
Self Pay $1 - $75 32%
Three Rivers $1 - $61 32%
UnitedHealthcare $1 - $68 32%
Encore Ppo $2 - $122 63%
First Health $2 - $102 63%
Multiplan $2 - $106 63%
Prime Health Services $2 - $102 63%
Sagamore $2 - $74 63%
Advantage Health Solutions $3 - $113 95%
Align Network $3 - $109 95%
Allied Benefit Systems $3 - $122 95%
Caresource $3 95%
Department Of Veterans Affairs $3 95%
Frontpath Health Coalition $3 - $109 95%
Humana $3 95%
In Dept Of Correction $3 95%
Managed Health Services $3 - $6 95%
Medicaid / KanCare $3 95%
Medical Mutual Of Ohio $3 - $136 95%
Medicare (plans) $3 95%
Node Devoted Health Mcr Adv $3 95%
Node Hospice Non Par Agree $3 95%
Node Pphp Mcr Adv $3 95%
Node Va $3 95%
Parkview Healthplan Services $3 - $136 95%
Php Freedom Network $3 - $6 95%
Tricare $3 95%
Value Options $3 - $136 95%
Veterans Eval Services $3 95%
Us Department Of Labor $4 126%
Lutheran Advanced Network $5 158%
Encore Work Comp In $6 189%
Work Comp $6 189%
Encore Kba Epo $8 252%
Encore Kba Ppo $10 315%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals