CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $4
Cash Discount Price: $56
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at The University of Vermont Health Network-Alice Hy is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 1.26x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $56 (1767%)

Insurance Median: $4 (126%)

Cash: $56 (1767% of Medicare)

Ins. Median: $4 (126% 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.

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
Capital District Physicians' Health Plan	$2 - $96	63%
UnitedHealthcare	$2 - $100	63%
Aetna	$3 - $88	95%
Blue Cross Blue Shield	$3 - $33	95%
Choicecare	$3 - $76	95%
Fidelis Care	$3 - $33	95%
Humana	$3 - $33	95%
Martins Point	$3 - $33	95%
Mvp	$3 - $85	95%
Veterans Affairs Community Care Network	$3 - $33	95%
St. Regis	$4 - $33	126%
Magnacare	$8 - $82	252%
Highmark Blueshield	$10 - $91	315%

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 $56.
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 The University of Vermont Health Network-Alice Hy 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.