CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Wooster Community Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $23
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 7.26x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Wooster Community Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 7.26x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $30 (946%)
Insurance Median: $23 (726%)
Cash: $30 (946% of Medicare)
Ins. Median: $23 (726% 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 726% of the Medicare baseline (a markup of 626%). 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.

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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
Blue Cross Blue Shield $3 - $6 95%
Buckeye Mcare $3 95%
Caresource Mcr Adv $3 95%
Humana $3 - $28 95%
Med Mutual Of Oh Mcr $3 95%
Molina Mcr $3 95%
Summacare Mcr $3 95%
The Health Plan Mcr Adv $3 95%
Tricare $3 95%
UnitedHealthcare $3 - $28 95%
Valor Hp Mcr-All Plans $3 95%
Magnipower-All Plans $4 126%
Caresource Exch - All Other Plans $5 158%
Molina Marketplace - All Other Plans $5 158%
Aetna $6 - $30 189%
Amerihealth Mcaid-All Plans $6 189%
Buckeye Mcaid-All Other Plans $6 189%
Caresource Mcaid $6 189%
Clarity Health - All Plans $6 189%
Molina Mcaid $6 189%
Aultcare/Primecare Mcr Adv $15 473%
Cerco-All Plans $21 662%
Aultcare Wayne County $22 694%
Aultcare/Primetime Exch $22 694%
Rayco-All Plans $22 694%
Christian Health Ministries-All Plans $24 757%
Cigna $24 757%
Health Ohio Network Employer $24 757%
Wayne County-All Plans $24 757%
Health Ohio Network Ppo-All Other Plans $25 789%
Healthsmart Accel $25 789%
Healthsmart Complete Ppo-All Other Plans $25 789%
Ohio Health Choice Supp $25 789%
Ohio Health Group Hlthy - All Other Plans $25 789%
Summacare Preferred Choice $25 789%
Health Plan Of Upper Ohio-All Plans $26 820%
Med Mutual Of Oh Exchange $26 820%
Med Mutual Of Oh Supermed $26 820%
Med Mutual Of Oh Trad-All Other Plans $26 820%
The Health Plan Comm - All Other Plans $26 820%
Aultcare/Primetime-All Other Plans $27 852%
Healthsmart Ppo $27 852%
Ohio Health Group Pref $27 852%
Healthsmart Hpo $28 883%
Ohio Health Choice-All Other Plans $28 883%
Osu-All Plans $28 883%
Summacare-All Other Plans $28 883%
Beech Street-All Plans $29 915%
Central Benefits-All Plans $29 915%
First Health-All Plans $29 915%
Flora-All Plans $29 915%
Phcs-All Plans $29 915%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals