CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Woodlawn Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $30
  • Cash Discount Price: $104
  • vs. Medicare Baseline: 9.46x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Woodlawn Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 9.46x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.
Cash / Self-Pay
$104

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $104 (3281%)
Insurance Median: $30 (946%)
Cash: $104 (3281% of Medicare)
Ins. Median: $30 (946% 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 946% of the Medicare baseline (a markup of 846%). 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
Blue Cross Blue Shield $2 - $105 63%
Caresource Mcaid Hww $3 95%
Mdwise Excel Hhw & Hcc $3 95%
Mhs Mcaid Hcc $3 95%
Mhs Mcaid Hhw $3 95%
UnitedHealthcare $3 - $105 95%
Partners Direct Health-All Plans $4 126%
Aetna $30 - $131 946%
Caresource Mcaid Hip $30 946%
Caresource Mcr Adv $30 946%
Humana $30 - $107 946%
Mdwise Mcaid Excel Hip $30 946%
Mhs Exch Mrktplce-All Other Plans $30 946%
Mhs Mcaid Hip $30 946%
Mhs Mcr Adv $31 978%
Caresource Exch - All Other Plans $39 1230%
Ambetter / Centene $40 1262%
Cigna $99 - $117 3123%
Parkview Health Plans-All Plans $104 3281%
Sagamore All Other Grps - All Other Plans $116 3659%
Encore Comm-All Plans $117 3691%
Phcs/Multiplan-All Plans $128 4038%
Community Health Alliance-All Plans $131 4132%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 E 9Th St, Rochester, IN 46975
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals