CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: St Louis Childrens Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $19
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 5.99x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at St Louis Childrens Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 5.99x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $16 (505%)
Insurance Median: $19 (599%)
Cash: $16 (505% of Medicare)
Ins. Median: $19 (599% 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 599% of the Medicare baseline (a markup of 499%). 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
Aetna $3 - $21 95%
Blue Cross Blue Shield $3 - $22 95%
Cox Health [757] $3 95%
Essence Healthcare [221] $3 95%
Humana $3 - $19 95%
Medica [662] $3 95%
UnitedHealthcare $3 - $19 95%
Healthscope Benefits [258] $4 - $21 126%
Cigna $13 - $14 410%
Healthlink [225] $13 - $20 410%
Apwu Health Plan [216] $14 442%
Consociate [478] $14 442%
Nalc Health Benefit Plan [242] $14 442%
Priority Health [648] $14 442%
Sarah Bush Lincoln [636] $14 442%
Allied Benefits [498] $15 - $21 473%
Hope Trust [806] $15 473%
Cox Health Systems Insurance Company [220] $17 - $19 536%
Med-Pay [480] $17 - $20 536%
Unicare [568] $17 - $20 536%
Health Alliance [224] $18 568%
First Health Commercial [734] $19 599%
Beechstreet [551] $20 631%
Detego Health [868] $20 631%
Health Systems Inc [620] $20 631%
Healthcare Sol Mercy [609] $20 631%
Multiplan Commercial [737] $20 631%
Multiplan [240] $20 631%
Phcs [244] $20 - $21 631%
Preferred Health Professionals [561] $20 631%
Coresource [497] $21 662%
Fmh Benefit Service Inc [222] $21 662%
Mail Handlers [495] $21 662%
Medica [661] $21 662%
Hfn [563] $22 694%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Childrens Place, Saint Louis, MO 63110
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens