CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Fairview Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $59
Cash Discount Price: $87
vs. Medicare Baseline: 18.61x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Fairview Hospital is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 18.61x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $87 (2744%)

Insurance Median: $59 (1861%)

Cash: $87 (2744% of Medicare)

Ins. Median: $59 (1861% 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 1861% of the Medicare baseline (a markup of 1761%). 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	$3 - $69	95%
Bmchnp	$3	95%
Capital District Physicians' Health Plan	$3 - $83	95%
Fallon	$3 - $40	95%
Health New England	$3 - $64	95%
Hospice	$3 - $36	95%
Medicaid / KanCare	$3	95%
Medicare (plans)	$3 - $35	95%
Other Government	$3 - $36	95%
Point32Health	$3 - $87	95%
UnitedHealthcare	$3 - $79	95%
Blue Cross Blue Shield	$4 - $78	126%
Commcare Alliance	$4 - $35	126%
Comm Fallon Qhp	$5 - $57	158%
Unicare	$8 - $60	252%
Workers Comp	$59	1861%
Allways Nhp	$60	1893%
Comm Hne Hmo	$61 - $69	1924%
Comm Hne Ppo	$64 - $69	2019%
Cigna	$83 - $86	2618%
Mvp	$83	2618%
Oxford	$83	2618%
First Health	$86 - $87	2713%
Connecticare	$87	2744%
Consolidated Health Plans	$87	2744%
Other Commercial	$87	2744%
Phcs	$87	2744%
Self Pay	$87	2744%

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 $87.
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 Fairview Hospital 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.