CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Pender Memorial Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $27
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 8.52x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Pender Memorial Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 8.52x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.
Cash / Self-Pay
$19

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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: $19 (599%)
Insurance Median: $27 (852%)
Cash: $19 (599% of Medicare)
Ins. Median: $27 (852% 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 852% of the Medicare baseline (a markup of 752%). 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
Humana $11 - $37 347%
Aetna $12 - $37 379%
Amerihealth $12 379%
Blue Cross Blue Shield $12 - $31 379%
Carolina Complete $12 379%
Cigna $12 - $19 379%
Nc Department Of Public Safety $12 - $23 379%
New Hanover Health $12 379%
Pace Of The Southern Piedmont $12 379%
Wellcare $12 379%
Ambetter / Centene $16 505%
Liberty Health $16 505%
Caresource North Carolina $17 536%
Plotkin Health $26 820%
UnitedHealthcare $31 978%
Medcost $32 - $36 1009%
Employers Choice Network $42 1325%
Three Rivers Provider Network $42 1325%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 507 E Fremont St, Burgaw, NC 28425
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals