CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Queens Hospital Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $12
Cash Discount Price: $3
vs. Medicare Baseline: 3.79x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Queens Hospital Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 3.79x the Medicare baseline. Located in 82-68 164Th Street, Jamaica, NY.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $3 (95%)

Insurance Median: $12 (379%)

Cash: $3 (95% of Medicare)

Ins. Median: $12 (379% 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 379% of the Medicare baseline (a markup of 279%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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%
Blue Cross Blue Shield	$3 - $100	95%
Centers Plan For Healthy Living	$3	95%
Elderplan	$3	95%
Fidelis	$3 - $100	95%
Healthfirst	$3 - $100	95%
Centerlight	$4 - $8	126%
Hamaspik	$4	126%
Magnacare	$4	126%
Oscar	$4 - $5	126%
Villagecare Max	$4 - $13	126%
Local 1199	$5 - $13	158%
Oxford	$5	158%
United	$5 - $48	158%
Wellcare	$5 - $9	158%
Affinity	$6 - $100	189%
Carelon	$10 - $44	315%
Emblem	$11 - $60	347%
Multiplan	$12	379%
Vnsny	$13 - $45	410%
Metroplus	$43 - $100	1356%
Amidacare	$44	1388%
Senior Whole Health	$44	1388%
United Behavioral Health	$44 - $49	1388%
Carelon (Amida Care)	$45	1420%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $3.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 81001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Queens Hospital Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 81001.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.