CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Reading Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $39
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 12.30x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Reading Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 12.30x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $68 (2145%)
Insurance Median: $39 (1230%)
Cash: $68 (2145% of Medicare)
Ins. Median: $39 (1230% 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 1230% of the Medicare baseline (a markup of 1130%). 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
Amerihealth Caritas $3 95%
Blue Cross Blue Shield $3 - $25 95%
Upmc $3 - $52 95%
Gateway $4 126%
Geisinger $4 - $61 126%
Health Partners $4 126%
Keystone First $4 126%
Pa Health & Wellness $4 126%
UnitedHealthcare $4 126%
Wernersville State Hospital $4 126%
Aetna $8 - $52 252%
Pma $39 1230%
Lehigh Valley Health Network $44 1388%
Cigna $55 1735%
First Health $58 1830%
Berkshire $73 2303%
Blue Ridge $92 2902%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 420 S 5Th Avenue, West Reading, PA 19611
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals