CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Elmhurst Hospital Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $30
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 9.46x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Elmhurst Hospital Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 9.46x the Medicare baseline. Located in 79-01 Broadway, Elmhurst, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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%)
Insurance Median: $30 (946%)
Ins. Median: $30 (946% 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 946% of the Medicare baseline (a markup of 846%). 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 $2 - $11 63%
Elderplan $3 95%
Fidelis $3 - $67 95%
Healthfirst $3 - $67 95%
Magnacare $4 126%
Oscar $5 158%
Oxford $5 158%
United $5 - $37 158%
Centerlight $8 252%
Wellcare $9 284%
Blue Cross Blue Shield $10 - $67 315%
Carelon $10 - $30 315%
Emblem $11 - $40 347%
Multiplan $12 379%
Local 1199 $13 410%
Villagecare Max $13 410%
Vnsny $13 - $30 410%
Metroplus $29 - $67 915%
Affinity $30 - $67 946%
Amidacare $30 946%
Carelon (Amida Care) $30 946%
Senior Whole Health $30 946%
United Behavioral Health $30 - $33 946%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 79-01 Broadway, Elmhurst, NY 11373
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals