CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Norton-King's Daughters' Health

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $65
Cash Discount Price: $18
vs. Medicare Baseline: 20.50x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Norton-King's Daughters' Health is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 20.50x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $18 (568%)

Insurance Median: $65 (2050%)

Cash: $18 (568% of Medicare)

Ins. Median: $65 (2050% 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 2050% of the Medicare baseline (a markup of 1950%). 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	$2 - $73	63%
Blue Cross Blue Shield	$3 - $10	95%
Humana	$3	95%
Managed Health Services	$3 - $5	95%
Managed Health Services Of Indiana	$3	95%
Managed Health Services Of Kentucky	$3	95%
Passport By Molina	$3	95%
UnitedHealthcare	$3 - $65	95%
Caresource Of Kentucky	$4	126%
Caresource Of Indiana	$5	158%
Custom Design Benefits	$6 - $42	189%
Cigna	$71	2240%
Encore	$71	2240%
Quality Care Partners	$74	2334%
Bluegrass	$75	2366%
First Health	$75	2366%
Healthlink	$75	2366%
Vha/Tristate	$75	2366%
Multiplan/Phcs	$76	2397%
Indiana Health Network	$79	2492%
Siho	$79	2492%

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 $18.
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 Norton-King's Daughters' Health 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.