CMS Price Transparency Data
Urinalysis (automated, with microscopy)
Facility: Mount Carmel East & West
Billing Code: 81001 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 81001
- Insurance Median: $9
- Cash Discount Price: $581
- vs. Medicare Baseline: 2.84x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Mount Carmel East & West is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $581. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 2.84x the Medicare baseline. Located in 6001 East Broad Street, Columbus, OH.
Cash / Self-Pay
$581
Average discount available for prompt cash payment at this facility.
Insurance Median
$9
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: $581 (18328%)
Insurance Median: $9 (284%)
Cash: $581 (18328% of Medicare)
Ins. Median: $9 (284% 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 284% of the Medicare baseline (a markup of 184%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 - $85 | 95% |
| Blue Benefit Administrators Of Massachusetts | $3 - $313 | 95% |
| Blue Care Network | $3 - $313 | 95% |
| Blue Cross Blue Shield | $3 - $313 | 95% |
| Blue Distinction Transplant | $3 - $313 | 95% |
| Blue Shield - Ca | $3 - $313 | 95% |
| Blue Shield - Id (Regence) | $3 - $313 | 95% |
| Blue Shield - Ny Highmark Northeastern | $3 - $313 | 95% |
| Blue Shield - Ny Highmark Western | $3 - $313 | 95% |
| Blue Shield - Pa (Highmark) | $3 - $313 | 95% |
| Blue Shield - Wa (Regence) | $3 - $313 | 95% |
| Hospice Mount Carmel | $3 - $82 | 95% |
| Medicare (plans) | $3 - $86 | 95% |
| Oscar | $3 - $82 | 95% |
| Rural Carrier Health Benefit Plan | $3 | 95% |
| The Health Plan | $3 - $84 | 95% |
| UnitedHealthcare | $3 - $324 | 95% |
| Enterprise Group Planning | $6 - $159 | 189% |
| Medical Mutual | $6 - $286 | 189% |
| Custom Design Benefits | $7 - $172 | 221% |
| Quality Care Partners | $7 - $186 | 221% |
| Western & Southern Financial Group | $8 - $286 | 252% |
| Access Health | $9 | 284% |
| Acclaim | $9 | 284% |
| Administrative Concepts | $9 | 284% |
| Allegeant | $9 | 284% |
| Allied Benefit Systems | $9 | 284% |
| American Family | $9 | 284% |
| American Healthcare Alliance | $9 | 284% |
| American National | $9 | 284% |
| American Republic | $9 | 284% |
| Amerihealth | $9 | 284% |
| Aultcare | $9 | 284% |
| Automated Benefit Services | $9 | 284% |
| Auxiant | $9 | 284% |
| Benefit Administrative Systems,Llc | $9 | 284% |
| Boon Chapman | $9 | 284% |
| Cam Administrative Services | $9 | 284% |
| Christian Brother Services | $9 | 284% |
| Christian Brothers Holy Cross | $9 | 284% |
| Claimchoice Adminstrators | $9 | 284% |
| Comprehensive Benefits | $9 | 284% |
| Continental Life Insurance | $9 | 284% |
| Coventry | $9 | 284% |
| Custom Benefit Administrators | $9 | 284% |
| Cypress Benefit Administrators | $9 | 284% |
| Employee Benefit Concepts | $9 | 284% |
| Employee Benefit Management | $9 | 284% |
| Forest County Potawatomi | $9 | 284% |
| Freedom Life Insurance Company | $9 | 284% |
| Geha | $9 - $324 | 284% |
| Gravie Admin Services | $9 | 284% |
| Group Administrators | $9 | 284% |
| Group Marketing Services | $9 | 284% |
| Group Pension Administrators | $9 | 284% |
| Guardian | $9 | 284% |
| Health America | $9 | 284% |
| Health Choices | $9 | 284% |
| Healthcare Management Admin | $9 | 284% |
| Healthez | $9 | 284% |
| Insight | $9 | 284% |
| Intercare | $9 | 284% |
| Jfp Benefit Management | $9 | 284% |
| Jp Farley Corporation | $9 | 284% |
| Key Benefit Administrator | $9 | 284% |
| Liberty Union Life Assurance Co | $9 | 284% |
| Lucent Health | $9 | 284% |
| Luminare Health | $9 | 284% |
| Magnacare | $9 | 284% |
| Medcost | $9 | 284% |
| Meritain | $9 | 284% |
| Mutual Health Services | $9 | 284% |
| Mutual Of Omaha | $9 | 284% |
| Ncas | $9 | 284% |
| Nippon Life Ins | $9 | 284% |
| Nova | $9 | 284% |
| Painters Union Insurance Fund | $9 | 284% |
| Physicians Mutual | $9 | 284% |
| Plumbers Local 98 Insurance Fund | $9 | 284% |
| Prairie States | $9 | 284% |
| Preferred One | $9 | 284% |
| Primary Physician Care | $9 | 284% |
| Professional Benefit Administrators | $9 | 284% |
| Secureone Preferred United Plans | $9 | 284% |
| Siho Insurance Services | $9 | 284% |
| Sisco Benefits | $9 | 284% |
| The Loomis Company | $9 | 284% |
| Trustmark Small Business Benefits | $9 | 284% |
| U Of M Health Plan | $9 | 284% |
| Unicare | $9 | 284% |
| Unified Group Services | $9 | 284% |
| Us Health And Life | $9 | 284% |
| Valenz | $9 | 284% |
| Varipro | $9 | 284% |
| Webtpa | $9 | 284% |
| Wps | $9 | 284% |
| Humana | $10 - $20 | 315% |
| First Health | $11 | 347% |
| Consociate | $12 | 379% |
| Health Ohio Network | $12 | 379% |
| Medben | $12 - $15 | 379% |
| American Postal Workers Secondary | $13 | 410% |
| Cigna | $13 | 410% |
| Health Partners | $13 | 410% |
| Healthgram | $13 | 410% |
| Mvp | $13 | 410% |
| Priority Health | $13 | 410% |
| Caresource | $15 | 473% |
| Healthlink Inc | $15 | 473% |
| Medical Benefits Mutual | $15 | 473% |
| Ohio Health Choice | $15 | 473% |
| Ohio Ppo Connect | $15 | 473% |
| Ameriben | $16 | 505% |
| Luminare Health (Detroit) | $16 | 505% |
| Medi Share | $16 | 505% |
| Multiplan | $16 | 505% |
| Ohiohealthy | $16 | 505% |
| Osu Not Independent Choice | $16 | 505% |
| Phcs | $16 | 505% |
| Philadelphia American Life Insurance | $16 | 505% |
| Twin Valley Psychiatric | $16 | 505% |
| Health Smart | $17 | 536% |
| Bccp | $20 | 631% |
| Medicaid / KanCare | $20 | 631% |
| Optima Health | $20 | 631% |
| Crime Victim Assistance | $632 | 19937% |
| Ohio Safe Program | $632 | 19937% |