CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $29
  • Cash Discount Price: $132
  • vs. Medicare Baseline: 9.15x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Hospital of Univ of Pennsylvania is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 9.15x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$132

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $132 (4164%)
Insurance Median: $29 (915%)
Cash: $132 (4164% of Medicare)
Ins. Median: $29 (915% 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 915% of the Medicare baseline (a markup of 815%). 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
Cigna $2 - $59 63%
Gspp And Wissahickon Hospice $2 63%
Aetna $3 - $132 95%
Blue Cross Blue Shield $3 - $76 95%
Clover Health Plan $3 95%
Devoted Health $3 95%
Geisinger Health Plan $3 - $10 95%
Health Partners $3 - $132 95%
Humana $3 - $106 95%
Ibc $3 95%
Kaiser Permanente $3 - $132 95%
Medicaid / KanCare $3 - $132 95%
Medicare (plans) $3 95%
Pa Health And Wellness $3 - $5 95%
Pa Medical Assistance $3 - $132 95%
Penn Life (Living Independently For Elders) $3 95%
Philadelphia Va Medical Center $3 95%
Tricare $3 95%
UnitedHealthcare $3 - $132 95%
Upmc $3 - $132 95%
Us Family Health Plan $3 95%
Elap $4 126%
Gateway Health Plan $4 126%
Keystone First $4 126%
Keystone Mercy Health Plan $4 - $132 126%
Claims Watcher $5 - $6 158%
Ibc Commercial Hpn $5 158%
Keystone Hmo Proactive $5 158%
Oscar Health Plan $5 158%
Centivo $6 189%
Elap Services $6 189%
Highmark $7 221%
Penn Global Medicine $8 252%
Paired Kidney Exchange $11 347%
Horizon Nj Health $22 - $23 694%
Preferred Health Care Eliance $29 915%
Pgm - Regie De L'Assurance Maladie Quebec $30 946%
Pgm - Kuwait Defense $46 - $59 1451%
Qualcare $50 1577%
Olympus $52 1640%
Coventry $53 - $67 1672%
Pgm - Chop $53 1672%
Wissahickon Hospice $53 1672%
Healthamerica/Coventry $59 - $65 1861%
First Health Global $66 2082%
Health Net $79 2492%
Pgm - Royal Embassy Of Saudi Arabia $79 2492%
Pgm - Embassy Of Qatar $86 2713%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $86 2713%
Interlink $88 2776%
Pgm - Embassy Of The United Emirates/Ipc $92 2902%
Health America/Ccn $106 3344%
Intergroup $106 3344%
Pgm - Kuwait Health Division $106 3344%
Pgm - Kuwait Oil $106 3344%
Preferred Care $106 3344%
Blue Quality Centers For Transplant (Bqct) $132 4164%
City Of Philadelphia Behavioral Health $132 4164%
Commercial Other $132 4164%
International Pfs $132 4164%
United Behavioral Health $132 4164%
Workers Compensation $132 4164%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals