CMS Price Transparency Data
Urinalysis (automated, with microscopy)
Facility: Mercy Health Lakeshore Campus
Billing Code: 81001 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 81001
- Insurance Median: $38
- Cash Discount Price: $130
- vs. Medicare Baseline: 11.99x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Mercy Health Lakeshore Campus is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 11.99x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$130
Average discount available for prompt cash payment at this facility.
Insurance Median
$38
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: $130 (4101%)
Insurance Median: $38 (1199%)
Cash: $130 (4101% of Medicare)
Ins. Median: $38 (1199% 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 1199% of the Medicare baseline (a markup of 1099%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 - $38 | 63% |
| Medicaid / KanCare | $2 | 63% |
| Blue Care Network Advantage | $3 | 95% |
| Medicare (plans) | $3 - $11 | 95% |
| U Of M Health Plan | $5 - $39 | 158% |
| Wellpath | $5 | 158% |
| Access Health | $8 | 252% |
| Aetna | $11 - $35 | 347% |
| Align Senior Care | $11 | 347% |
| Correctional Recovery | $11 | 347% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $12 | 379% |
| Oscar | $14 | 442% |
| UnitedHealthcare | $15 - $40 | 473% |
| Vitalcore | $15 | 473% |
| Molina Marketplace | $18 | 568% |
| Hospice Of Michigan | $24 | 757% |
| Nomi Health | $25 | 789% |
| Hap | $33 - $40 | 1041% |
| Geha | $35 - $40 | 1104% |
| Meritain | $35 | 1104% |
| Wc Accident Fund | $35 | 1104% |
| Wc Advantage | $35 | 1104% |
| Wc Aig | $35 | 1104% |
| Wc Allied | $35 | 1104% |
| Wc Amerisure | $35 | 1104% |
| Wc Amtrust | $35 | 1104% |
| Wc Asu Risk Mgt | $35 | 1104% |
| Wc Berkley Admin | $35 | 1104% |
| Wc Broadspire | $35 | 1104% |
| Wc Bunch & Associates | $35 | 1104% |
| Wc Ccmsi | $35 | 1104% |
| Wc Emc Insurance Company | $35 | 1104% |
| Wc Esis | $35 | 1104% |
| Wc Fcci | $35 | 1104% |
| Wc Federated | $35 | 1104% |
| Wc Gallagher Bassett | $35 | 1104% |
| Wc Genex Care For Ohio | $35 | 1104% |
| Wc Guard Insurance Company | $35 | 1104% |
| Wc Hartford | $35 | 1104% |
| Wc Liberty Mutual | $35 | 1104% |
| Wc Meijers | $35 | 1104% |
| Wc Michigan | $35 | 1104% |
| Wc Mitchell Frankenmuth | $35 | 1104% |
| Wc Pma | $35 | 1104% |
| Wc Sedgwick | $35 | 1104% |
| Wc Sentry | $35 | 1104% |
| Wc Travelers | $35 | 1104% |
| Wc Tristar | $35 | 1104% |
| Wc Walmart | $35 | 1104% |
| Wc Zurich | $35 | 1104% |
| Asr Health Benefits | $37 | 1167% |
| 1199 National Benefit Fund | $38 | 1199% |
| Allied National Global Care | $38 | 1199% |
| Asrm - Reliance Standard Life Insurance | $38 | 1199% |
| Bcn Domestic | $38 | 1199% |
| Blue Benefit Administrators Of Massachusetts | $38 | 1199% |
| Blue Care Network | $38 | 1199% |
| Blue Distinction Transplant | $38 | 1199% |
| Blue Shield - Ca | $38 | 1199% |
| Blue Shield - Id (Regence) | $38 | 1199% |
| Blue Shield - Ny Highmark Northeastern | $38 | 1199% |
| Blue Shield - Ny Highmark Western | $38 | 1199% |
| Blue Shield - Pa (Highmark) | $38 | 1199% |
| Blue Shield - Wa (Regence) | $38 | 1199% |
| Christian Care Ministry | $38 | 1199% |
| Cigna | $38 | 1199% |
| Dean Health | $38 | 1199% |
| Fallon Health | $38 | 1199% |
| Family Life Insurance Company | $38 | 1199% |
| Ghc Scw | $38 | 1199% |
| Group Pension Administrators | $38 | 1199% |
| Health Choices | $38 - $39 | 1199% |
| International Benefit Administrators | $38 | 1199% |
| Kaiser Domestic | $38 | 1199% |
| Lifetime Benefit Solutions | $38 | 1199% |
| Manhattan Life | $38 | 1199% |
| Medi Share | $38 | 1199% |
| Multiplan | $38 | 1199% |
| Mvp | $38 | 1199% |
| Pai | $38 | 1199% |
| Pan-American Life | $38 | 1199% |
| Paramount Hmo | $38 | 1199% |
| Phcs | $38 | 1199% |
| Trinity Health Share | $38 | 1199% |
| Acclaim | $39 | 1230% |
| Administrative Concepts | $39 | 1230% |
| Allegeant | $39 | 1230% |
| Allied Benefit Systems | $39 | 1230% |
| Ameriben | $39 | 1230% |
| American Family | $39 | 1230% |
| American Healthcare Alliance | $39 | 1230% |
| American Republic | $39 | 1230% |
| Amerihealth | $39 | 1230% |
| Aultcare | $39 | 1230% |
| Automated Benefit Services | $39 | 1230% |
| Auxiant | $39 | 1230% |
| Benefit Administrative Systems,Llc | $39 | 1230% |
| Boon Chapman | $39 | 1230% |
| Cam Administrative Services | $39 | 1230% |
| Caresource | $39 | 1230% |
| Christian Brother Services | $39 | 1230% |
| Christian Brothers Holy Cross | $39 | 1230% |
| Claimchoice Adminstrators | $39 | 1230% |
| Comprehensive Benefits | $39 | 1230% |
| Consociate | $39 | 1230% |
| Continental Life Insurance | $39 | 1230% |
| Custom Benefit Administrators | $39 | 1230% |
| Cypress Benefit Administrators | $39 | 1230% |
| Employee Benefit Concepts | $39 | 1230% |
| Employee Benefit Management | $39 | 1230% |
| Enterprise Group Planning | $39 | 1230% |
| Forest County Potawatomi | $39 | 1230% |
| Freedom Life Insurance Company | $39 | 1230% |
| Group Administrators | $39 | 1230% |
| Group Marketing Services | $39 | 1230% |
| Guardian | $39 | 1230% |
| Health America | $39 | 1230% |
| Health Smart | $39 | 1230% |
| Healthez | $39 | 1230% |
| Healthgram | $39 | 1230% |
| Healthscope | $39 | 1230% |
| Humana | $39 | 1230% |
| Insight | $39 | 1230% |
| Intercare | $39 | 1230% |
| Jfp Benefit Management | $39 | 1230% |
| Jp Farley Corporation | $39 | 1230% |
| Key Benefit Administrator | $39 | 1230% |
| Liberty Union Life Assurance Co | $39 | 1230% |
| Lucent Health | $39 | 1230% |
| Luminare Health | $39 | 1230% |
| Luminare Health (Detroit) | $39 | 1230% |
| Medben | $39 | 1230% |
| Medcost | $39 | 1230% |
| Medical Mutual | $39 | 1230% |
| Mutual Health Services | $39 | 1230% |
| Mutual Of Omaha | $39 | 1230% |
| Ncas | $39 | 1230% |
| Nippon Life Ins | $39 | 1230% |
| Nova | $39 | 1230% |
| Painters Union Insurance Fund | $39 | 1230% |
| Physicians Mutual | $39 | 1230% |
| Plumbers Local 98 Insurance Fund | $39 | 1230% |
| Prairie States | $39 | 1230% |
| Primary Physician Care | $39 | 1230% |
| Professional Benefit Administrators | $39 | 1230% |
| Secureone Preferred United Plans | $39 | 1230% |
| The Loomis Company | $39 | 1230% |
| Trustmark Small Business Benefits | $39 | 1230% |
| Unicare | $39 | 1230% |
| Unified Group Services | $39 | 1230% |
| Us Health And Life | $39 | 1230% |
| Valenz | $39 | 1230% |
| Varipro | $39 - $40 | 1230% |
| Western & Southern Financial Group | $39 | 1230% |
| Wps | $39 | 1230% |
| First Health | $40 | 1262% |
| Priority Health | $40 | 1262% |