CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Carolina East Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $24
Cash Discount Price: $35
vs. Medicare Baseline: 7.57x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Carolina East Medical Center is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 7.57x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$35

Average discount available for prompt cash payment at this facility.

Insurance Median

$24

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: $35 (1104%)

Insurance Median: $24 (757%)

Cash: $35 (1104% of Medicare)

Ins. Median: $24 (757% 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 757% of the Medicare baseline (a markup of 657%). 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
Humana	$3	95%
Inclusive Health (Nchirp)-All Plans	$3	95%
Tricare	$3 - $89	95%
Pamlico Co Jail-All Plans	$7 - $24	221%
Craven Co. Jail Systems - All Plans	$8 - $30	252%
UnitedHealthcare	$9 - $63	284%
Medcost Ppo Employees And Retirees	$17 - $58	536%
Medcost Ppo Ultra (Employees)	$17 - $56	536%
Blue Cross Blue Shield	$18 - $61	568%
Medcost Ppo City Employees	$19 - $65	599%
Medcost Ppo County Employee	$20 - $67	631%
Benefit Mgmt, Svcs-All Plans	$22 - $76	694%
Acs Consult Svc Inc-All Plans	$23 - $80	726%
Aetna	$23 - $79	726%
Medcost Benefit Svc-All Other Plans	$23 - $79	726%
Medcost Ppo Standard	$23 - $80	726%
Cigna	$24 - $81	757%

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 $35.
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 Carolina East Medical Center 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.