CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Perham Health

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $21
Cash Discount Price: $37
vs. Medicare Baseline: 6.62x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Perham Health is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 6.62x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

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: $37 (1167%)

Insurance Median: $21 (662%)

Cash: $37 (1167% of Medicare)

Ins. Median: $21 (662% 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 662% of the Medicare baseline (a markup of 562%). 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	$16 - $39	505%
Health Partners Mcr Adv	$19 - $20	599%
Humana	$19 - $20	599%
Medica Mcr Adv	$19 - $20	599%
Medicare (plans)	$19 - $22	599%
Ucare Mn Senior Health Options	$19 - $20	599%
Ucare Mn Special Needs Basic Care Dual	$20 - $21	631%
UnitedHealthcare	$20 - $45	631%
Medica Mcaid Mn Care	$21	662%
Medicaid / KanCare	$21	662%
Ucare Mn Medical Assistance	$21	662%
Ucare Mn Minnesota Care	$21	662%
Ucare Mn Senior Care Plus	$21	662%
Ucare Mn Special Needs Basic Care	$21	662%
Medica Mn (Msho)	$23 - $24	726%
Ucare Individual And Family Plan-All Other Plans	$24	757%
Medica Mn Senior Hp/Outside Mn	$26	820%
Health Partners Minnesota Care	$28 - $29	883%
Medica Commercial-All Other Plans	$42	1325%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$43 - $44	1356%
Health Partners-All Plans	$47 - $48	1483%
Preferred One (Ppo)	$48 - $49	1514%
Sanford Health Plan-All Plans	$48 - $49	1514%

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 $37.
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 Perham Health 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.