CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Ohio Valley Surgical Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $11,885
  • Cash Discount Price: $45
  • vs. Medicare Baseline: 3749.21x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Ohio Valley Surgical Hospital is $11,885. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 3749.21x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$45

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,885

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: $45 (1420%)
Insurance Median: $11,885 (374921%)
Cash: $45 (1420% of Medicare)
Ins. Median: $11,885 (374921% 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 374921% of the Medicare baseline (a markup of 374821%). 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
Blue Cross Blue Shield $2 - $40,293 63%
Aetna $4 - $20,896 126%
Geha $4 - $20,896 126%
Genworth $4 - $20,896 126%
Mail Handlers $4 - $20,896 126%
Meritain $4 - $20,896 126%
Meritain Heatlh $4 - $20,896 126%
Mhbp $4 - $20,896 126%
Ngs Coresource $4 - $20,896 126%
Nippon Life $4 - $20,896 126%
Pacific Source $4 - $20,896 126%
Personify Health $4 - $20,896 126%
UnitedHealthcare $4 - $17,571 126%
Mmo Cin. Hmo $34 - $47 1073%
Mmoh $34 - $11,885 1073%
Mmoh (Supermed) $34 - $35 1073%
Medicare (plans) $45 - $12,264 1420%
Luminare Health $68 2145%
Medben $68 2145%
Ohio Health $68 2145%
Preferred Health $68 2145%
Medicaid / KanCare $3,557 - $17,827 112208%
Amerihealth Caritas Of Ohio $3,657 115363%
Buckeye Community Health Plan $4,022 126877%
Molina Mcd $4,084 128833%
Caresource $4,364 - $17,827 137666%
Humana $4,493 - $11,919 141735%
Aarp $11,885 374921%
Aarp Supplemental $11,885 374921%
American Continental Insurance $11,885 374921%
American Continental Life $11,885 374921%
American Republic $11,885 374921%
American Retirement $11,885 374921%
Aultcare Primetime Health Plan $11,885 374921%
Bankers Fidelity $11,885 374921%
Bankers Life And Casualty $11,885 374921%
Central States $11,885 374921%
Champus $11,885 374921%
Cigna $11,885 - $18,817 374921%
Communicare Advantage $11,885 374921%
Everest $11,885 374921%
Gateway Health Plan $11,885 374921%
Medigold $11,885 374921%
Molina $11,885 374921%
Molina Dual Mcr $11,885 374921%
Molina Marketplace $11,885 374921%
Molina Dual Mcr $11,885 374921%
Molina Mcr $11,885 374921%
Molina Mcr Mcd $11,885 374921%
Molina Mcr+Mcd $11,885 374921%
Patient No Pay $11,885 374921%
Prosperity Supplement $11,885 374921%
Self Pay Imaging $11,885 374921%
Wellcare By Allwell $11,885 374921%
Wraparound Pl Supp $11,885 374921%
The Health Plan $12,479 393659%
Devoted Health $13,707 432397%
Employer Direct $15,703 495363%
Golden Rule $17,571 554290%
Medica $17,571 554290%
Oxford $17,571 554290%
Shl $17,571 554290%
Surest $17,571 554290%
Ushealth $17,571 554290%
Caresourse $17,827 562366%
Healthgram $18,817 593596%
Nalc $18,817 593596%
Samba $18,817 593596%
Sbma $18,817 593596%
Unified Group $18,817 593596%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals