CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: North Carolina Baptist Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $17
  • Cash Discount Price: $25
  • vs. Medicare Baseline: 5.36x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at North Carolina Baptist Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 5.36x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$25

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $25 (789%)
Insurance Median: $17 (536%)
Cash: $25 (789% of Medicare)
Ins. Median: $17 (536% 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 536% of the Medicare baseline (a markup of 436%). 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 - $43 95%
Apex $3 95%
Blue Cross Blue Shield $3 - $19 95%
Cigna $3 - $31 95%
Devoted $3 95%
Healthteam $3 95%
Humana $3 - $28 95%
Medicare (plans) $3 95%
UnitedHealthcare $3 - $18 95%
Wellcare $3 - $6 95%
Liberty $4 126%
Alliance $6 189%
Amerihealth $6 - $12 189%
Carolina Complete $6 189%
Health Blue $6 189%
Partners $6 189%
Trillium $6 189%
Vaya $6 189%
Medcost $8 - $34 252%
Ambetter / Centene $11 - $12 347%
Oscar $14 - $18 442%
Directnet $28 - $30 883%
Cone Health $34 - $36 1073%
Healthgram $34 - $36 1073%
First Carolina Care $38 - $41 1199%
Private Healthcare Systems $39 - $42 1230%
Multiplan $43 - $46 1356%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals