CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Licking Memorial Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $99
  • Cash Discount Price: $138
  • vs. Medicare Baseline: 31.23x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Licking Memorial Hospital is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $138. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 31.23x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$138

Average discount available for prompt cash payment at this facility.

Insurance Median
$99

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: $138 (4353%)
Insurance Median: $99 (3123%)
Cash: $138 (4353% of Medicare)
Ins. Median: $99 (3123% 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 3123% of the Medicare baseline (a markup of 3023%). 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
Aetna $3 - $100 95%
Blue Cross Blue Shield $3 - $118 95%
Champva [500001] $3 95%
Cigna $3 - $124 95%
Humana $3 - $134 95%
Medicare (plans) $3 95%
Tricare $3 95%
UnitedHealthcare $3 - $117 95%
Veterans Administration [100068] $3 95%
Wellcare By Allwell [450104] $3 95%
Molina Marketplace [100106] $5 158%
Medical Mutual [100114] $76 - $114 2397%
Medben [700068] $96 - $135 3028%
Allied Benefit Systems [100015] $99 3123%
Geha [100039] $99 3123%
Gravie Administrative Services [100165] $99 3123%
Meritain [100063] $99 3123%
Optima [700069] $99 3123%
Trustmark Small Business Benefits [100263] $99 3123%
Webtpa [100127] $99 3123%
Benicomp [70090] $103 3249%
Consociate Health 6 Degrees [100059] $110 3470%
Consociate Health [100029] $110 3470%
Healthscope [100157] $117 3691%
Surest [100016] $117 3691%
United Medical Resources [700071] $117 3691%
American Postal Workers [100089] $124 3912%
Antidote Health Plan Of Ohio [70006803] $124 3912%
Coresource [100002] $124 - $138 3912%
Great West Life [700064] $124 3912%
National Association Of Letter Carriers [100067] $124 3912%
Ohio Healthy Luminare Health [100264] $124 3912%
Ohio Healthy [100255] $124 3912%
Ohio Ppo Connect [70006801] $124 3912%
Osu Prime Care [100254] $124 3912%
Quality Care Partners [70006802] $124 3912%
The Health Plan [100261] $124 3912%
Wellfleet Group, Llc [100164] $124 3912%
Coventry [100010] $127 4006%
Pan American Life [700070] $127 4006%
Ohio Health Choice [100109] $132 4164%
Administrative Concepts [100006] $134 4227%
Carefactor [100087] $134 4227%
Philadelphia American Life [100260] $134 - $138 4227%
Reliance Standard-Asrm [100258] $134 4227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals