CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: St Joseph's University Medical Center Inc

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $7
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 2.21x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at St Joseph's University Medical Center Inc is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 2.21x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $70 (2208%)
Insurance Median: $7 (221%)
Cash: $70 (2208% of Medicare)
Ins. Median: $7 (221% 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 221% of the Medicare baseline (a markup of 121%). 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
UnitedHealthcare $1 - $7 32%
Wellpoint $1 - $3 32%
Aetna $3 - $14 95%
Amerihealth $3 - $45 95%
Blue Cross Blue Shield $3 - $61 95%
Clover Health $3 95%
Fidelis Care of New Jersey $3 - $14 95%
Horizon New Jersey Total Care $3 95%
Consumer Health Network $4 - $63 126%
Horizon New Jersey Health $4 126%
Longevity Health Plan $4 126%
Ambetter / Centene $5 158%
Oxford $7 221%
Private Healthcare Systems $46 1451%
Magnacare $49 1546%
Multiplan $52 1640%
Oscar $66 2082%
Cigna $70 2208%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 703 Main St, Paterson, NJ 07503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals