CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Pennsylvania Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $67
  • Cash Discount Price: $195
  • vs. Medicare Baseline: 21.14x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Pennsylvania Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $195. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 21.14x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$195

Average discount available for prompt cash payment at this facility.

Insurance Median
$67

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: $195 (6151%)
Insurance Median: $67 (2114%)
Cash: $195 (6151% of Medicare)
Ins. Median: $67 (2114% 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 2114% of the Medicare baseline (a markup of 2014%). 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 - $66 63%
Aetna $3 - $195 95%
Blue Cross Blue Shield $3 - $195 95%
Clover Health Plan $3 95%
Gateway Health Plan $3 - $4 95%
Geisinger Health Plan $3 - $10 95%
Health Partners $3 - $195 95%
Humana $3 - $156 95%
Ibc $3 95%
Medicaid / KanCare $3 - $195 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 - $195 95%
Upmc $3 - $195 95%
Us Family Health Plan $3 95%
Elap $4 126%
Keystone First $4 126%
Keystone Mercy Health Plan $4 126%
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 $33 - $34 1041%
Pgm - Regie De L'Assurance Maladie Quebec $45 1420%
Preferred Health Care Eliance $51 1609%
Pgm - Kuwait Defense $68 - $88 2145%
Devon $74 - $88 2334%
Qualcare $74 2334%
Coventry $78 - $99 2461%
Pgm - Chop $78 2461%
Wissahickon Hospice $78 2461%
Healthamerica/Coventry $88 - $96 2776%
Olympus $95 2997%
First Health Global $98 3091%
Urn-Cancer Resource Services $98 3091%
Health Net $117 3691%
Pgm - Royal Embassy Of Saudi Arabia $117 3691%
Pgm - Embassy Of Qatar $127 4006%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $127 4006%
Pgm - Embassy Of The United Emirates/Ipc $136 4290%
Devon Health Services Inc $156 4921%
Health America/Ccn $156 4921%
Intergroup $156 4921%
Pgm - Kuwait Health Division $156 4921%
Pgm - Kuwait Oil $156 4921%
Preferred Care $156 4921%
Commercial Other $195 6151%
Community Behavioral Health $195 6151%
International Pfs $195 6151%
Quest Behavioral Health $195 6151%
United Behavioral Health $195 6151%
Workers Compensation $195 6151%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals