CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $29
  • Cash Discount Price: $22
  • vs. Medicare Baseline: 9.15x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Alice Peck Day Memorial Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 9.15x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.
Cash / Self-Pay
$22

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $22 (694%)
Insurance Median: $29 (915%)
Cash: $22 (694% of Medicare)
Ins. Median: $29 (915% 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 915% of the Medicare baseline (a markup of 815%). 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
Ambetter / Centene $3 95%
Amerihealth Caritas Granite Mcmp $3 95%
Medicaid / KanCare $3 95%
Nh Healthy Families $3 95%
Blue Cross Blue Shield $12 - $36 379%
Wellpoint $18 568%
Harvard Pilgrim $25 - $35 789%
Tufts $29 915%
UnitedHealthcare $29 915%
Cigna $31 - $33 978%
Commercial Generic $31 978%
Connecticut General $31 978%
Klais $31 978%
Aetna $36 1136%
Mvp $36 1136%
Coventry Health $38 1199%
Coventry Health Wc $38 1199%
Humana $42 1325%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Alice Peck Day Drive, Lebanon, NH 03766
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals