CMS Price Transparency Data
Urinalysis (automated, with microscopy)
Facility: Trinity Health Oakland Hospital
Billing Code: 81001 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 81001
- Insurance Median: $16
- Cash Discount Price: $209
- vs. Medicare Baseline: 5.05x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Trinity Health Oakland Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $209. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 5.05x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$209
Average discount available for prompt cash payment at this facility.
Insurance Median
$16
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: $209 (6593%)
Insurance Median: $16 (505%)
Cash: $209 (6593% of Medicare)
Ins. Median: $16 (505% 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 505% of the Medicare baseline (a markup of 405%). 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.
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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 - $3 | 63% |
| Medicaid / KanCare | $2 | 63% |
| Aetna | $3 - $24 | 95% |
| Align Senior Care | $3 | 95% |
| Bcn Domestic | $3 | 95% |
| Blue Benefit Administrators Of Massachusetts | $3 | 95% |
| Blue Care Network | $3 | 95% |
| Blue Care Network Advantage | $3 | 95% |
| Blue Distinction Transplant | $3 | 95% |
| Blue Shield - Ca | $3 | 95% |
| Blue Shield - Id (Regence) | $3 | 95% |
| Blue Shield - Ny Highmark Northeastern | $3 | 95% |
| Blue Shield - Ny Highmark Western | $3 | 95% |
| Blue Shield - Pa (Highmark) | $3 | 95% |
| Blue Shield - Wa (Regence) | $3 | 95% |
| Cca - Zing Health | $3 | 95% |
| Health Choices | $3 - $38 | 95% |
| Hospice Advantage | $3 | 95% |
| Kaiser Domestic | $3 | 95% |
| Medicare (plans) | $3 | 95% |
| UnitedHealthcare | $3 - $39 | 95% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $4 | 126% |
| Molina Marketplace | $4 | 126% |
| Geha | $5 - $39 | 158% |
| Health Cost Solutions | $5 | 158% |
| Medical Mutual | $5 | 158% |
| Meritain | $5 | 158% |
| Priority Health | $5 | 158% |
| U Of M Health Plan | $5 | 158% |
| Vitalcore | $5 | 158% |
| Wellpath | $5 | 158% |
| Employee Benefit Logistic | $7 | 221% |
| Asr Health Benefits | $10 | 315% |
| Caresource | $10 | 315% |
| Hap | $10 - $38 | 315% |
| Varipro | $10 | 315% |
| Wc Accident Fund | $16 | 505% |
| Wc Advantage | $16 | 505% |
| Wc Aig | $16 | 505% |
| Wc Allied | $16 | 505% |
| Wc Amerisure | $16 | 505% |
| Wc Amtrust | $16 | 505% |
| Wc Asu Risk Mgt | $16 | 505% |
| Wc Berkley Admin | $16 | 505% |
| Wc Broadspire | $16 | 505% |
| Wc Bunch & Associates | $16 | 505% |
| Wc Ccmsi | $16 | 505% |
| Wc Emc Insurance Company | $16 | 505% |
| Wc Esis | $16 | 505% |
| Wc Fcci | $16 | 505% |
| Wc Federated | $16 | 505% |
| Wc Gallagher Bassett | $16 | 505% |
| Wc Genex Care For Ohio | $16 | 505% |
| Wc Guard Insurance Company | $16 | 505% |
| Wc Hartford | $16 | 505% |
| Wc Liberty Mutual | $16 | 505% |
| Wc Meijers | $16 | 505% |
| Wc Michigan | $16 | 505% |
| Wc Mitchell Frankenmuth | $16 | 505% |
| Wc Pma | $16 | 505% |
| Wc Sedgwick | $16 | 505% |
| Wc Sentry | $16 | 505% |
| Wc Travelers | $16 | 505% |
| Wc Tristar | $16 | 505% |
| Wc Walmart | $16 | 505% |
| Wc Zurich | $16 | 505% |
| Acs Benefit Services | $23 | 726% |
| Allied Benefit Systems | $23 | 726% |
| Claimchoice Adminstrators | $23 | 726% |
| Consociate | $23 | 726% |
| Cypress Benefit Administrators | $23 | 726% |
| Forest County Potawatomi | $23 | 726% |
| Health Smart | $23 | 726% |
| Healthgram | $23 | 726% |
| Healthscope | $23 | 726% |
| Secureone Preferred United Plans | $23 | 726% |
| Sisco Benefits | $23 | 726% |
| The Health Plan | $23 | 726% |
| Trustmark Small Business Benefits | $23 | 726% |
| Unified Group Services | $23 | 726% |
| Webtpa | $23 | 726% |
| Mclaren Health | $25 - $27 | 789% |
| Carelon Behavioral Health | $26 | 820% |
| Magellan Behavioral Health | $31 | 978% |
| 1199 National Benefit Fund | $35 | 1104% |
| Allied National Global Care | $35 | 1104% |
| Asrm - Reliance Standard Life Insurance | $35 | 1104% |
| Christian Care Ministry | $35 | 1104% |
| Dean Health | $35 | 1104% |
| Fallon Health | $35 | 1104% |
| Family Life Insurance Company | $35 | 1104% |
| Ghc Scw | $35 | 1104% |
| Group Pension Administrators | $35 | 1104% |
| International Benefit Administrators | $35 | 1104% |
| Lifetime Benefit Solutions | $35 | 1104% |
| Manhattan Life | $35 | 1104% |
| Medi Share | $35 | 1104% |
| Multiplan | $35 | 1104% |
| Mvp | $35 | 1104% |
| Pai | $35 | 1104% |
| Pan-American Life | $35 | 1104% |
| Paramount Hmo | $35 | 1104% |
| Phcs | $35 | 1104% |
| Trinity Health Share | $35 | 1104% |
| Access Health | $38 | 1199% |
| Acclaim | $38 | 1199% |
| Administrative Concepts | $38 | 1199% |
| Allegeant | $38 | 1199% |
| Ameriben | $38 | 1199% |
| American Family | $38 | 1199% |
| American Healthcare Alliance | $38 | 1199% |
| American National | $38 | 1199% |
| American Republic | $38 | 1199% |
| Amerihealth | $38 | 1199% |
| Aultcare | $38 | 1199% |
| Automated Benefit Services | $38 | 1199% |
| Auxiant | $38 | 1199% |
| Benefit Administrative Systems,Llc | $38 | 1199% |
| Boon Chapman | $38 | 1199% |
| Cam Administrative Services | $38 | 1199% |
| Christian Brother Services | $38 | 1199% |
| Christian Brothers Holy Cross | $38 | 1199% |
| Comprehensive Benefits | $38 | 1199% |
| Continental Life Insurance | $38 | 1199% |
| Custom Benefit Administrators | $38 | 1199% |
| Employee Benefit Concepts | $38 | 1199% |
| Employee Benefit Management | $38 | 1199% |
| Enterprise Group Planning | $38 | 1199% |
| Freedom Life Insurance Company | $38 | 1199% |
| Group Administrators | $38 | 1199% |
| Group Marketing Services | $38 | 1199% |
| Guardian | $38 | 1199% |
| Health America | $38 | 1199% |
| Health Partners | $38 | 1199% |
| Healthcare Management Admin | $38 | 1199% |
| Healthez | $38 | 1199% |
| Humana | $38 | 1199% |
| Insight | $38 | 1199% |
| Intercare | $38 | 1199% |
| Jfp Benefit Management | $38 | 1199% |
| Jp Farley Corporation | $38 | 1199% |
| Key Benefit Administrator | $38 | 1199% |
| Liberty Union Life Assurance Co | $38 | 1199% |
| Lucent Health | $38 | 1199% |
| Luminare Health | $38 | 1199% |
| Luminare Health (Detroit) | $38 | 1199% |
| Magnacare | $38 | 1199% |
| Medben | $38 | 1199% |
| Medcost | $38 | 1199% |
| Mutual Health Services | $38 | 1199% |
| Mutual Of Omaha | $38 | 1199% |
| Ncas | $38 | 1199% |
| Nippon Life Ins | $38 | 1199% |
| Nova | $38 | 1199% |
| Painters Union Insurance Fund | $38 | 1199% |
| Physicians Mutual | $38 | 1199% |
| Plumbers Local 98 Insurance Fund | $38 | 1199% |
| Prairie States | $38 | 1199% |
| Preferred One | $38 | 1199% |
| Primary Physician Care | $38 | 1199% |
| Professional Benefit Administrators | $38 | 1199% |
| Siho Insurance Services | $38 | 1199% |
| The Loomis Company | $38 | 1199% |
| Tufts Health Plan | $38 | 1199% |
| Unicare | $38 | 1199% |
| Us Health And Life | $38 | 1199% |
| Valenz | $38 | 1199% |
| Western & Southern Financial Group | $38 | 1199% |
| Wps | $38 | 1199% |
| Cigna | $39 | 1230% |
| Coventry | $39 | 1230% |
| First Health | $39 | 1230% |
| Prime Health Services | $42 | 1325% |
| Three Rivers Provider Network | $47 | 1483% |
| Cmh Detroit Wayne Integrated Health Network | $52 | 1640% |
| Cmh Lenawee County | $52 | 1640% |
| Cmh Livingston County | $52 | 1640% |
| Cmh Misc | $52 | 1640% |
| Cmh Monroe County | $52 | 1640% |
| Cmh Oakland County | $52 | 1640% |
| Cmh Washtenaw County | $52 | 1640% |