CMS Price Transparency Data
Urinalysis (automated, with microscopy)
Facility: Trinity Health Muskegon Hospital
Billing Code: 81001 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 81001
- Insurance Median: $33
- Cash Discount Price: $132
- vs. Medicare Baseline: 10.41x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Trinity Health Muskegon Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 10.41x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$132
Average discount available for prompt cash payment at this facility.
Insurance Median
$33
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: $132 (4164%)
Insurance Median: $33 (1041%)
Cash: $132 (4164% of Medicare)
Ins. Median: $33 (1041% 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 1041% of the Medicare baseline (a markup of 941%). 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 |
|---|---|---|
| Access Health | $2 - $81 | 63% |
| Blue Cross Blue Shield | $2 - $131 | 63% |
| Medicaid / KanCare | $2 - $76 | 63% |
| Aetna | $3 - $131 | 95% |
| Align Senior Care | $3 - $131 | 95% |
| Blue Care Network Advantage | $3 - $131 | 95% |
| Correctional Recovery | $3 - $116 | 95% |
| Heartland Hospice | $3 - $116 | 95% |
| Hospice Harbor Hospice | $3 - $116 | 95% |
| Medicare (plans) | $3 - $131 | 95% |
| Oscar | $3 - $116 | 95% |
| UnitedHealthcare | $3 - $131 | 95% |
| Bcn Domestic | $4 | 126% |
| Blue Benefit Administrators Of Massachusetts | $4 | 126% |
| Blue Care Network | $4 | 126% |
| Blue Distinction Transplant | $4 | 126% |
| Blue Shield - Ca | $4 | 126% |
| Blue Shield - Id (Regence) | $4 | 126% |
| Blue Shield - Ny Highmark Northeastern | $4 | 126% |
| Blue Shield - Ny Highmark Western | $4 | 126% |
| Blue Shield - Pa (Highmark) | $4 | 126% |
| Blue Shield - Wa (Regence) | $4 | 126% |
| Health Choices | $4 - $35 | 126% |
| Kaiser Domestic | $4 | 126% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $4 - $131 | 126% |
| Molina Marketplace | $4 - $151 | 126% |
| Geha | $5 - $39 | 158% |
| Meritain | $5 | 158% |
| U Of M Health Plan | $5 - $35 | 158% |
| Vitalcore | $5 - $220 | 158% |
| Wellpath | $5 - $180 | 158% |
| Acs Benefit Services | $23 | 726% |
| Allied Benefit Systems | $23 | 726% |
| Asr Health Benefits | $23 | 726% |
| Claimchoice Adminstrators | $23 | 726% |
| Consociate | $23 | 726% |
| Cypress Benefit Administrators | $23 | 726% |
| Forest County Potawatomi | $23 | 726% |
| Hap | $23 - $35 | 726% |
| Health Smart | $23 | 726% |
| Healthgram | $23 | 726% |
| Healthscope | $23 | 726% |
| Preferred One | $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% |
| Wc Accident Fund | $23 | 726% |
| Wc Advantage | $23 | 726% |
| Wc Aig | $23 | 726% |
| Wc Allied | $23 | 726% |
| Wc Amerisure | $23 | 726% |
| Wc Amtrust | $23 | 726% |
| Wc Asu Risk Mgt | $23 | 726% |
| Wc Berkley Admin | $23 | 726% |
| Wc Broadspire | $23 | 726% |
| Wc Bunch & Associates | $23 | 726% |
| Wc Ccmsi | $23 | 726% |
| Wc Emc Insurance Company | $23 | 726% |
| Wc Esis | $23 | 726% |
| Wc Fcci | $23 | 726% |
| Wc Federated | $23 | 726% |
| Wc Gallagher Bassett | $23 | 726% |
| Wc Genex Care For Ohio | $23 | 726% |
| Wc Guard Insurance Company | $23 | 726% |
| Wc Hartford | $23 | 726% |
| Wc Liberty Mutual | $23 | 726% |
| Wc Meijers | $23 | 726% |
| Wc Michigan | $23 | 726% |
| Wc Mitchell Frankenmuth | $23 | 726% |
| Wc Pma | $23 | 726% |
| Wc Sedgwick | $23 | 726% |
| Wc Sentry | $23 | 726% |
| Wc Travelers | $23 | 726% |
| Wc Tristar | $23 | 726% |
| Wc Walmart | $23 | 726% |
| Wc Zurich | $23 | 726% |
| Webtpa | $23 | 726% |
| Hospice Of Michigan | $24 | 757% |
| Nomi Health | $25 | 789% |
| Varipro | $25 | 789% |
| Caresource | $28 | 883% |
| Cigna | $28 | 883% |
| 1199 National Benefit Fund | $33 | 1041% |
| Allied National Global Care | $33 | 1041% |
| Asrm - Reliance Standard Life Insurance | $33 | 1041% |
| Christian Care Ministry | $33 | 1041% |
| Dean Health | $33 | 1041% |
| Fallon Health | $33 | 1041% |
| Family Life Insurance Company | $33 | 1041% |
| Ghc Scw | $33 | 1041% |
| Group Pension Administrators | $33 | 1041% |
| International Benefit Administrators | $33 | 1041% |
| Lifetime Benefit Solutions | $33 | 1041% |
| Manhattan Life | $33 | 1041% |
| Medi Share | $33 | 1041% |
| Multiplan | $33 | 1041% |
| Mvp | $33 | 1041% |
| Pai | $33 | 1041% |
| Pan-American Life | $33 | 1041% |
| Paramount Hmo | $33 | 1041% |
| Phcs | $33 | 1041% |
| Trinity Health Share | $33 | 1041% |
| Acclaim | $35 | 1104% |
| Administrative Concepts | $35 | 1104% |
| Allegeant | $35 | 1104% |
| Ameriben | $35 | 1104% |
| American Family | $35 | 1104% |
| American Healthcare Alliance | $35 | 1104% |
| American Republic | $35 | 1104% |
| Amerihealth | $35 | 1104% |
| Aultcare | $35 | 1104% |
| Automated Benefit Services | $35 | 1104% |
| Auxiant | $35 | 1104% |
| Benefit Administrative Systems,Llc | $35 | 1104% |
| Boon Chapman | $35 | 1104% |
| Cam Administrative Services | $35 | 1104% |
| Christian Brother Services | $35 | 1104% |
| Christian Brothers Holy Cross | $35 | 1104% |
| Comprehensive Benefits | $35 | 1104% |
| Continental Life Insurance | $35 | 1104% |
| Custom Benefit Administrators | $35 | 1104% |
| Employee Benefit Concepts | $35 | 1104% |
| Employee Benefit Management | $35 | 1104% |
| Enterprise Group Planning | $35 | 1104% |
| Freedom Life Insurance Company | $35 | 1104% |
| Group Administrators | $35 | 1104% |
| Group Marketing Services | $35 | 1104% |
| Guardian | $35 | 1104% |
| Health America | $35 | 1104% |
| Healthez | $35 | 1104% |
| Humana | $35 | 1104% |
| Insight | $35 | 1104% |
| Intercare | $35 | 1104% |
| Jfp Benefit Management | $35 | 1104% |
| Jp Farley Corporation | $35 | 1104% |
| Key Benefit Administrator | $35 | 1104% |
| Liberty Union Life Assurance Co | $35 | 1104% |
| Lucent Health | $35 | 1104% |
| Luminare Health | $35 | 1104% |
| Luminare Health (Detroit) | $35 | 1104% |
| Medben | $35 | 1104% |
| Medcost | $35 | 1104% |
| Medical Mutual | $35 | 1104% |
| Mutual Health Services | $35 | 1104% |
| Mutual Of Omaha | $35 | 1104% |
| Ncas | $35 | 1104% |
| Nippon Life Ins | $35 | 1104% |
| Nova | $35 | 1104% |
| Painters Union Insurance Fund | $35 | 1104% |
| Physicians Mutual | $35 | 1104% |
| Plumbers Local 98 Insurance Fund | $35 | 1104% |
| Prairie States | $35 | 1104% |
| Primary Physician Care | $35 | 1104% |
| Priority Health | $35 - $39 | 1104% |
| Professional Benefit Administrators | $35 | 1104% |
| The Loomis Company | $35 | 1104% |
| Unicare | $35 | 1104% |
| Us Health And Life | $35 | 1104% |
| Valenz | $35 | 1104% |
| Western & Southern Financial Group | $35 | 1104% |
| Wps | $35 | 1104% |
| First Health | $36 | 1136% |
| Barinet | $44 | 1388% |
| Cmh Allegan County | $44 | 1388% |
| Cmh Barry County | $44 | 1388% |
| Cmh Berrien County | $44 | 1388% |
| Cmh Cass County | $44 | 1388% |
| Cmh Kalamazoo | $44 | 1388% |
| Cmh Kent County | $44 | 1388% |
| Cmh Misc | $44 | 1388% |
| Cmh Muskegon County | $44 | 1388% |
| Cmh North Country | $44 | 1388% |
| Cmh Northern Lakes County | $44 | 1388% |
| Cmh Ottawa County | $44 | 1388% |
| Cmh Van Buren County | $44 | 1388% |
| Cmh West Mi County | $44 | 1388% |