CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Sanford Wheaton Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $68
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 21.45x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Sanford Wheaton Medical Center is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 21.45x the Medicare baseline. Located in 401 12Th Street North, Wheaton, MN.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$68

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: $62 (1956%)
Insurance Median: $68 (2145%)
Cash: $62 (1956% of Medicare)
Ins. Median: $68 (2145% 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 2145% of the Medicare baseline (a markup of 2045%). 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.

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 $19 - $72 599%
Sanford Health Plan Align $39 1230%
Ucare $42 - $69 1325%
Aetna $43 - $68 1356%
Health Partners $43 - $63 1356%
Medicare (plans) $43 1356%
Primewest $43 - $47 1356%
Security Health Plan $43 1356%
UnitedHealthcare $43 - $65 1356%
Sanford Health Plan $62 - $72 1956%
Medica $69 - $74 2177%
First Choice Health Network $70 2208%
Healthez $70 2208%
Multiplan $70 2208%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 12Th Street North, Wheaton, MN 56296
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals