CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Mainehealth Maine Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $31
Cash Discount Price: $42
vs. Medicare Baseline: 9.78x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Mainehealth Maine Medical Center is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 9.78x the Medicare baseline. Located in 22 Bramhall St, Portland, ME.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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: $42 (1325%)

Insurance Median: $31 (978%)

Cash: $42 (1325% of Medicare)

Ins. Median: $31 (978% 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 978% of the Medicare baseline (a markup of 878%). 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
Blue Cross Blue Shield	$2 - $33	63%
Aetna	$3 - $86	95%
Harvard Pilgrim Healthcare	$3 - $90	95%
Humana	$3 - $14	95%
UnitedHealthcare	$3 - $94	95%
Wellcare	$3 - $15	95%
Community Health Options	$6 - $88	189%
Cigna	$30 - $86	946%
Multiplan	$33 - $95	1041%

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 $42.
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 Mainehealth Maine Medical Center 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.