CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Atrium Health Cleveland

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $32
Cash Discount Price: $40
vs. Medicare Baseline: 10.09x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Atrium Health Cleveland is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 10.09x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $40 (1262%)

Insurance Median: $32 (1009%)

Cash: $40 (1262% of Medicare)

Ins. Median: $32 (1009% 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 1009% of the Medicare baseline (a markup of 909%). 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
Aetna	$3 - $62	95%
Cigna	$3 - $65	95%
Humana	$3	95%
UnitedHealthcare	$3 - $43	95%
Alliance	$4 - $14	126%
Amerihealth Caritas	$4 - $11	126%
Blue Cross Blue Shield	$4 - $33	126%
Carolina Complete Health	$4 - $12	126%
Choicecare	$4 - $66	126%
Healthy Blue	$4 - $12	126%
Partners	$4 - $11	126%
Trillium	$4 - $12	126%
Vaya	$4 - $12	126%
Wellcare	$4 - $12	126%
Employers Health Network	$6 - $43	189%
Medcost	$7 - $54	221%
Ambetter / Centene	$26 - $29	820%
Physician Reach Out	$40	1262%
Magellan	$48	1514%
Gmmi	$52	1640%
Quik Trip	$52	1640%
Carolina Behavioral Health	$58 - $65	1830%
Healthgram	$65	2050%
First Health	$69	2177%
Lifesynch Community Choice Care	$69	2177%
Private Health Care Systems	$73	2303%
Beechstreet	$74	2334%
Multiplan	$77	2429%

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 $40.
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 Atrium Health Cleveland 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.