CMS Price Transparency Data
Urinalysis (automated, with microscopy)
Facility: Saint Joseph Regional Medical Center - Plymouth
Billing Code: 81001 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 81001
- Insurance Median: $6
- Cash Discount Price: $189
- vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Saint Joseph Regional Medical Center - Plymouth is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $189. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 1.89x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$189
Average discount available for prompt cash payment at this facility.
Insurance Median
$6
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: $189 (5962%)
Insurance Median: $6 (189%)
Cash: $189 (5962% of Medicare)
Ins. Median: $6 (189% 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.
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 - $42 | 63% |
| Blue Cross Blue Shield | $2 - $6 | 63% |
| Medicaid / KanCare | $2 - $3 | 63% |
| UnitedHealthcare | $2 - $55 | 63% |
| County Coroner | $3 | 95% |
| Managed Health Services - Indiana | $3 | 95% |
| Mdwise | $3 | 95% |
| Medicare (plans) | $3 | 95% |
| Meridian Complete | $3 | 95% |
| Pace-Trinity Health | $3 | 95% |
| Provider Partners Health Plan Of Indiana | $3 | 95% |
| Auxiant | $5 - $72 | 158% |
| Caresource | $5 | 158% |
| Physicians Health Plan Northern Indiana Health Insurance | $5 - $10 | 158% |
| Siho Insurance Services | $5 | 158% |
| St Joseph County Hlth Dpt | $5 | 158% |
| Allied Benefit Systems | $6 - $57 | 189% |
| Blue Benefit Administrators Of Massachusetts | $6 | 189% |
| Blue Care Network | $6 | 189% |
| Blue Distinction Transplant | $6 | 189% |
| Blue Shield - Ca | $6 | 189% |
| Blue Shield - Id (Regence) | $6 | 189% |
| Blue Shield - Ny Highmark Northeastern | $6 | 189% |
| Blue Shield - Ny Highmark Western | $6 | 189% |
| Blue Shield - Pa (Highmark) | $6 | 189% |
| Blue Shield - Wa (Regence) | $6 | 189% |
| Key Benefit Administrator | $6 - $61 | 189% |
| Custom Design Benefits | $7 | 221% |
| Plain Church Group | $23 | 726% |
| Asr Health Benefits | $42 | 1325% |
| Christian Brother Services | $42 | 1325% |
| Employee Benefit Management | $42 | 1325% |
| Medical Mutual | $42 | 1325% |
| Meritain | $42 | 1325% |
| Preferred One | $42 | 1325% |
| Rural Carrier Health Benefit Plan | $42 | 1325% |
| Webtpa | $42 | 1325% |
| Notre Dame Athletic Association | $48 | 1514% |
| Wc Notre Dame | $48 | 1514% |
| Luminare Health (Detroit) | $50 - $52 | 1577% |
| Ameriben | $52 | 1640% |
| Geha | $55 | 1735% |
| Healthscope | $55 | 1735% |
| Student Insurance Cma | $55 | 1735% |
| Encore Health | $61 | 1924% |
| Indiana Criminal Justice Inst | $61 | 1924% |
| Western & Southern Financial Group | $61 | 1924% |
| Cigna | $63 | 1987% |
| Group Administrators | $63 | 1987% |
| Health Partners | $63 | 1987% |
| Mvp | $63 | 1987% |
| Prairie States | $63 | 1987% |
| Priority Health | $63 | 1987% |
| Professional Benefit Administrators | $63 | 1987% |
| Sagamore Health Network | $63 - $67 | 1987% |
| Sisco Benefits | $63 | 1987% |
| Unified Group Services | $63 | 1987% |
| Goshen Preferred Network | $67 - $75 | 2114% |
| Signature Care | $72 | 2271% |
| Allied National Global Care | $78 | 2461% |
| Asrm - Reliance Standard Life Insurance | $78 | 2461% |
| Avmed Health Plan | $78 | 2461% |
| Christian Care Ministry | $78 | 2461% |
| Dean Health | $78 | 2461% |
| Fallon Health | $78 | 2461% |
| Family Life Insurance Company | $78 | 2461% |
| Freedom Life Insurance Company | $78 | 2461% |
| Ghc Scw | $78 | 2461% |
| International Benefit Administrators | $78 | 2461% |
| Lifetime Benefit Solutions | $78 | 2461% |
| Manhattan Life | $78 | 2461% |
| Medi Share | $78 | 2461% |
| Multiplan | $78 | 2461% |
| Pai | $78 | 2461% |
| Pan-American Life | $78 | 2461% |
| Paramount Hmo | $78 | 2461% |
| Phcs | $78 | 2461% |
| Philadelphia American Life Insurance | $78 | 2461% |
| Trinity Health Share | $78 | 2461% |
| Bankers Life Casualty | $87 | 2744% |
| Bureau Of Disability | $87 | 2744% |
| Wc Align Network | $87 | 2744% |