CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $10
Cash Discount Price: $53
vs. Medicare Baseline: 3.15x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Nationwide Children's Hospital Toledo, LLC is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 3.15x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$53

Average discount available for prompt cash payment at this facility.

Insurance Median

$10

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: $53 (1672%)

Insurance Median: $10 (315%)

Cash: $53 (1672% of Medicare)

Ins. Median: $10 (315% 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 315% of the Medicare baseline (a markup of 215%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Caresource	$3	95%
Mcclaren Health Plan - Michigan	$3	95%
Molina	$3 - $7	95%
Cigna	$5	158%
Amerihealth	$7	221%
Bchp	$7	221%
Blue Cross Blue Shield	$7 - $45	221%
Humana	$7	221%
UnitedHealthcare	$7 - $44	221%
Front Path Health Coalition	$10 - $40	315%
Mmo	$22 - $31	694%
Aetna	$34	1073%
Mcclaren Health Plan	$40	1262%
Ohc	$44	1388%
Ohio Ppo Connect	$44	1388%
First Health	$68	2145%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $53.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 81001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Nationwide Children's Hospital Toledo, LLC is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 81001.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.