CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Mercy Hospital Ada

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $8
  • Cash Discount Price: $11
  • vs. Medicare Baseline: 2.52x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Mercy Hospital Ada is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 2.52x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$11

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: $11 (347%)
Insurance Median: $8 (252%)
Cash: $11 (347% 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 - $13 95%
Blue Cross Blue Shield $3 95%
Cherokee Nation Health Serv Contracted [320066] $3 95%
Cigna $3 95%
Cross Timbers Hospice [20098] $3 95%
Dept Of Veteran Affairs Contracted [320106] $3 95%
Elara Caring Aspire Hospice Contracted [320433] $3 95%
Elara Caring Aspire Hospice [20433] $3 95%
Globalhealth Contracted [320145] $3 95%
Halo Hcr Inc Hospice Contracted [320432] $3 95%
Halo Hcr Inc Hospice [20432] $3 95%
Humana $3 95%
Independent Health [20197] $3 95%
Indian Health Service Contracted [320198] $3 95%
Kindful Hospice Contracted [320434] $3 95%
Kindful Hospice [20434] $3 95%
Medicaid / KanCare $3 - $4 95%
Medical Associates Health [20444] $3 95%
Medicare (plans) $3 - $17 95%
Mercy Hospice Okc [20252] $3 95%
Provider Partners Health Plans Contracted [320450] $3 95%
Qual Choice Contracted [320325] $3 95%
Tricare $3 95%
UnitedHealthcare $3 - $4 95%
Ambetter / Centene $4 126%
Health Choice Contracted [320166] $4 126%
Home State Health Plan Contracted [320187] $4 126%
Medica Contracted [320239] $4 - $17 126%
Novasys Contracted [320285] $4 126%
United Medical Resources Contracted [320454] $4 - $10 126%
Healthcare Highways Plus Contracted [320175] $7 - $13 221%
Healthsmart Preferred Care Contracted [320184] $7 221%
Kempton Contracted [320214] $7 221%
Webtpa Contracted [320417] $7 221%
Benefit Management Contracted [320052] $8 - $11 252%
Osma Health Contracted [320292] $8 252%
Workers Comp [20426] $8 252%
Aither Health Contracted [320449] $10 315%
Auxiant Contracted [320462] $10 315%
Ebms Contracted [320493] $10 315%
Federal Medical Center Contracted [320127] $10 315%
Healthlink Contracted [320179] $10 315%
Healthscope Contracted [320182] $10 315%
Imagine 360 Contracted [320494] $10 315%
Mercy Benefit Admin Contracted [320251] $10 - $11 315%
Point C Contracted [320238] $10 315%
Preferred Health Plan Contracted [320522] $10 315%
Quik Trip Contracted [320447] $10 315%
Reflect Health Contracted [320492] $10 315%
Show-Me Health Administrators Contracted [320483] $10 315%
Yuzu Health Contracted [320521] $10 315%
Globalhealth Contracted [320144] $11 347%
First Health Contracted [320128] $14 442%
Multiplan Contracted [320270] $14 442%
Private Health Care Systems Contracted [320320] $14 442%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 North Monte Vista, Ada, OK 74820
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals