CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Hillcrest Hospital Pryor

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $116
Cash Discount Price: $54
vs. Medicare Baseline: 36.59x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Hillcrest Hospital Pryor is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 36.59x the Medicare baseline. Located in 111 North Bailey Street, Pryor, OK.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $54 (1703%)

Insurance Median: $116 (3659%)

Cash: $54 (1703% of Medicare)

Ins. Median: $116 (3659% 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 3659% of the Medicare baseline (a markup of 3559%). 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
Black Lung [6055]	$45	1420%
Healthcare Highways [2210]	$45 - $116	1420%
Hooray Health [8000]	$45	1420%
Lucent Health [6000]	$45	1420%
Oncology Patient Assistance Programs [2295]	$45	1420%
Oscar Insurance Company [7005]	$45	1420%
Osma Health Network [2345]	$45	1420%
Healthscope Benefits [2290]	$55	1735%
UnitedHealthcare	$55	1735%
The Kempton Group Administrators [2905]	$81	2555%
Beacon Health Options Behavioral Health [2890]	$111	3502%
Global Health [1430]	$111	3502%
Resource One Administrators [2815]	$116	3659%
Universal Fidelity [2085]	$116	3659%
Web Tpa [2115]	$116	3659%
First Health [1375]	$132	4164%
Medica [2910]	$132	4164%
Multiplan [1680]	$132	4164%
Cigna	$147	4637%
Healthpartners [1500]	$147	4637%
Pba [1775]	$147	4637%
Pending Ssi [1616]	$179	5647%

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 $54.
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 Hillcrest Hospital Pryor 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.