CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Southwest General Health Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $44
  • Cash Discount Price: $61
  • vs. Medicare Baseline: 13.88x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Southwest General Health Center is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 13.88x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.
Cash / Self-Pay
$61

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $61 (1924%)
Insurance Median: $44 (1388%)
Cash: $61 (1924% of Medicare)
Ins. Median: $44 (1388% 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 1388% of the Medicare baseline (a markup of 1288%). 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
Medical Mutual $1 - $2 32%
Medical Mutual-Ohio $1 32%
Buckeye $4 - $53 126%
Molina $4 - $53 126%
Cigna $7 221%
Healthsmart $26 820%
Health Design Plus $30 946%
Clarity Health $32 1009%
Healthspan $32 1009%
Humana $32 - $53 1009%
Healthsmart Preferred $36 1136%
Ohio Health Choice Plus $39 1230%
Aetna $44 1388%
Summacare $44 1388%
UnitedHealthcare $44 - $53 1388%
Amerihealth Caritas $53 1672%
Blue Cross Blue Shield $53 1672%
Caresource $53 1672%
Coventry $56 1767%
First Health $56 1767%
Ohio Health Choice $63 1987%
Private Healthare Systems $65 2050%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18697 Bagley Road, Middleburg Heights, OH 44130
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals