CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Portsmouth Regional Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $17
  • Cash Discount Price: $234
  • vs. Medicare Baseline: 5.36x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Portsmouth Regional Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 5.36x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.
Cash / Self-Pay
$234

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: $234 (7382%)
Insurance Median: $17 (536%)
Cash: $234 (7382% 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 - $148 95%
Amerihealth Caritas $3 95%
Blue Cross Blue Shield $3 - $104 95%
Cigna $3 - $17 95%
Evernorth Behavioral Health $3 95%
Humana $3 95%
Martin'S Point Health $3 95%
Sierra Military Health $3 95%
United $3 - $154 95%
United Behavioral Health $3 95%
United Va Ccn $3 95%
Well Sense Health Plan $3 95%
Ambetter / Centene $6 189%
Harvard Pilgrim $12 - $100 379%
Maine Community Health $73 - $124 2303%
Tufts Health Plan $88 - $134 2776%
Mvp Health Plan $164 5174%
Corvel $168 5300%
Evernorth $187 5899%
Mutual Of Omaha $187 5899%
Multiplan $190 5994%
First Health $213 6719%
Healthcare Value Mgmt $213 6719%
Oxford Health Plans $222 7003%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 333 Borthwick Ave, Portsmouth, NH 03801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals