CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: St Mary's Healthcare

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $45
  • Cash Discount Price: $57
  • vs. Medicare Baseline: 14.20x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at St Mary's Healthcare is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 14.20x the Medicare baseline. Located in 427 Guy Park Avenue, Amsterdam, NY.
Cash / Self-Pay
$57

Average discount available for prompt cash payment at this facility.

Insurance Median
$45

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: $57 (1798%)
Insurance Median: $45 (1420%)
Cash: $57 (1798% of Medicare)
Ins. Median: $45 (1420% 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 1420% of the Medicare baseline (a markup of 1320%). 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 - $80 95%
Blue Cross Blue Shield $3 - $75 95%
Humana $3 95%
Medicare (plans) $3 - $4 95%
Tricare $3 95%
Va $3 95%
Medicaid / KanCare $11 - $12 347%
UnitedHealthcare $11 347%
Carelon_Commercial $40 - $54 1262%
Carelon_Empire $40 - $54 1262%
Emblem_Commercial $48 - $64 1514%
Cdphp_Commercial $56 - $75 1767%
Excellus_Commercial $59 - $79 1861%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 427 Guy Park Avenue, Amsterdam, NY 12010
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals