CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Cleveland Clinic Avon Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $8
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 2.52x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Cleveland Clinic Avon Hospital is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 2.52x the Medicare baseline. Located in 33300 Cleveland Clinic Blvd, Avon, OH.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $14 (442%)
Insurance Median: $8 (252%)
Cash: $14 (442% of Medicare)
Ins. Median: $8 (252% 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 252% of the Medicare baseline (a markup of 152%). 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 - $21 95%
Cigna $3 - $8 95%
Communicare $3 95%
Devoted Health $3 95%
Humana $3 95%
Mmo $3 - $9 95%
Perennial Health $3 95%
Summacare $3 - $8 95%
The Health Plan $3 - $13 95%
United $3 - $5 95%
UnitedHealthcare $3 - $13 95%
Upmc $3 - $13 95%
Valor $3 95%
Blue Cross Blue Shield $5 - $14 158%
Buckeye $5 158%
Caresource $5 158%
Molina $5 158%
Oscar $6 - $8 189%
Zing Health $6 189%
Cc Ehp $8 - $9 252%
Amish Community Aid Plan $9 - $10 284%
Aultcare $9 284%
Ohcp $10 315%
Omas $10 315%
Ohio Healthy $11 347%
Php $13 410%
Gms $15 473%
Medical Benefit Corp $15 473%
Consociate Health $16 505%
Frontpath $19 599%
Managed Care Services $19 599%
Multiplan $19 599%
Tertiary Care Network $19 599%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 33300 Cleveland Clinic Blvd, Avon, OH 44011
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals