CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Adventist Health Portland

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $13
  • Cash Discount Price: $25
  • vs. Medicare Baseline: 4.10x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Adventist Health Portland is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 4.10x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$25

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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: $25 (789%)
Insurance Median: $13 (410%)
Cash: $25 (789% of Medicare)
Ins. Median: $13 (410% 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 410% of the Medicare baseline (a markup of 310%). 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 $2 - $3 63%
Healthnet Epo/Pos/Ppo $2 - $3 63%
Healthnet Hmo/Pos - All Other Plans $2 - $3 63%
Pacific Source Comm - All Plans $2 - $3 63%
Providence Hp - All Plans $2 - $3 63%
Care Oregon - All Plans $3 95%
Humana $3 95%
Kaiser Mcr Adv $3 95%
Moda Mcr Adv $3 95%
Ods - All Plans $3 95%
UnitedHealthcare $3 - $136 95%
Healthnet Mcr Adv $4 126%
Ah Employee Health Plan - All Plans $6 189%
Moda Conn Oebb/Syn Pebb $6 189%
Moda Affinity - All Other Plans $7 221%
Cigna $8 252%
Kaiser - All Other Plans $8 252%
Regence Ohsu Plus $8 252%
Regence - All Other Plans $9 284%
Moda Select $10 315%
Moda Connexus $11 347%
Moda Synergy $12 379%
Healthcare Resources - All Plans $14 - $20 442%
Workers Comp $22 - $31 694%
Bc Premera First - All Plans $32 - $46 1009%
Worldventure - All Plans $38 - $55 1199%
Regence Preferred Mcr Adv $41 - $59 1293%
First Choice - All Plans $44 - $63 1388%
Multiplan - All Plans $47 - $68 1483%
Phcs - All Plans $47 - $68 1483%
Regence Mcr Adv $48 - $69 1514%
First Health-Coventry - All Plans $50 - $73 1577%
National Provider Network - All Plans $55 - $80 1735%
Health Payors Organization Ltd- All Plans $57 - $82 1798%
Moda Ohsu Ppo/Epo/Hmc $113 - $164 3565%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals