CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Penn Presbyterian Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $48
  • Cash Discount Price: $137
  • vs. Medicare Baseline: 15.14x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Penn Presbyterian Medical Center is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $137. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 15.14x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$137

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $137 (4322%)
Insurance Median: $48 (1514%)
Cash: $137 (4322% of Medicare)
Ins. Median: $48 (1514% 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 1514% of the Medicare baseline (a markup of 1414%). 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 - $43 63%
Aetna $3 - $137 95%
Blue Cross Blue Shield $3 - $137 95%
Clover Health Plan $3 95%
Geisinger Health Plan $3 - $10 95%
Health Partners $3 - $137 95%
Humana $3 - $110 95%
Ibc $3 95%
Medicaid / KanCare $3 - $137 95%
Medicare (plans) $3 95%
Pa Health And Wellness $3 - $5 95%
Pa Medical Assistance $3 95%
Penn Life (Living Independently For Elders) $3 95%
Philadelphia Va Medical Center $3 95%
Tricare $3 95%
UnitedHealthcare $3 - $137 95%
Upmc $3 - $137 95%
Us Family Health Plan $3 95%
Elap $4 126%
Gateway Health Plan $4 126%
Keystone First $4 126%
Keystone Mercy Health Plan $4 - $137 126%
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%
Horizon Nj Health $23 - $24 726%
Pgm - Regie De L'Assurance Maladie Quebec $32 1009%
Preferred Health Care Eliance $34 1073%
Pgm - Kuwait Defense $48 - $62 1514%
Devon $52 - $62 1640%
Qualcare $52 1640%
Coventry $55 - $70 1735%
Pgm - Chop $55 1735%
Wissahickon Hospice $55 1735%
Healthamerica/Coventry $62 - $67 1956%
Olympus $65 2050%
First Health Global $68 2145%
Urn-Cancer Resource Services $68 2145%
Health Net $82 2587%
Pgm - Royal Embassy Of Saudi Arabia $82 2587%
Pgm - Embassy Of Qatar $89 2808%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $89 2808%
Pgm - Embassy Of The United Emirates/Ipc $96 3028%
Devon Health Services Inc $110 3470%
Health America/Ccn $110 3470%
Intergroup $110 3470%
Pgm - Kuwait Health Division $110 3470%
Pgm - Kuwait Oil $110 3470%
Preferred Care $110 3470%
Commercial Other $137 4322%
International Pfs $137 4322%
Magellan $137 4322%
Quest Behavioral Health $137 4322%
United Behavioral Health $137 4322%
Workers Compensation $137 4322%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals