CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Cambridge Health Alliance

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $20
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 6.31x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Cambridge Health Alliance is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 6.31x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$20

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: $20 (631%)
Insurance Median: $20 (631%)
Cash: $20 (631% of Medicare)
Ins. Median: $20 (631% 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 631% of the Medicare baseline (a markup of 531%). 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
Boston Medical Center - Wellsense [50003] $3 95%
Fallon [50006] $3 95%
Mass Bh Partnership [70098] $3 95%
Mass General Brigham [50021] $3 - $13 95%
Mass Health [70001] $3 95%
Medicaid / KanCare $3 95%
Medicare (plans) $3 - $20 95%
Other Tufts Health Public Plan [75002] $3 - $5 95%
Tufts Together W Cha [75001] $3 95%
UnitedHealthcare $3 - $10 95%
Aarp [40001] $4 126%
Oxford Health [40004] $4 126%
United Medical Resource [40005] $4 126%
Wc [90001] $4 126%
Blue Cross Blue Shield $6 - $20 189%
Wellpoint [50012] $6 189%
Aetna $8 - $20 252%
Cigna $9 - $22 284%
Tufts Health Plan [30001] $9 - $10 284%
Health Plans Inc [20002] $10 315%
Hphc [20001] $10 315%
Multiplan [50010] $14 442%
Altus Dental [99011] $20 631%
Beacon Health Strategies [50002] $20 631%
Cbhc Uninsured Crisis Alt Payer [70097] $20 631%
Cbhc Uninsured Crisis [70096] $20 631%
Celticare [50004] $20 631%
Commonwealth Care Alliance Dental [99004] $20 631%
Coverage Discovery [90004] $20 631%
Delta Dental Of Ma [99007] $20 631%
Dominion National Dental [99012] $20 631%
Dph Tb Payor [85004] $20 631%
Esp Dental [99003] $20 631%
Eyemed Alt Payor [13001] $20 631%
First Health [50007] $20 631%
Global Medical Management [50024] $20 631%
Government Employee Health Association [50023] $20 631%
Guardian Dental [99013] $20 631%
Health Safety Net Dental [99002] $20 631%
Humana $20 631%
Ma Laborers Health And Welfare Fund [50022] $20 631%
Magellan Health Services [65098] $20 631%
Mass Health Dental [99001] $20 631%
Medical Mutual Of Ohio [50019] $20 631%
Metlife Dental [99008] $20 631%
Modern Assistance Program [30098] $20 631%
Mva [90002] $20 631%
Neighborhood Health Plan [50011] $20 631%
Other Bh Payor [50014] $20 631%
Other Commercial Payor [50015] $20 631%
Other Dental Payor [99014] $20 631%
Other Dual Eligible Payer [65004] $20 631%
Other Gov'T Alt [85006] $20 631%
Other Vision Payor [50013] $20 631%
Ri Neighborhood Health Plan [50017] $20 631%
Tricare $20 631%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1493 Cambridge Street, Cambridge, MA 02139
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals