CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: St Mary Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $6
  • Cash Discount Price: $152
  • vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at St Mary Medical Center is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 1.89x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$152

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $152 (4795%)
Insurance Median: $6 (189%)
Cash: $152 (4795% of Medicare)
Ins. Median: $6 (189% 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.

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 $3 - $66 95%
Align Senior Care $3 95%
Blue Cross Blue Shield $3 - $39 95%
Cigna $3 - $17 95%
Medicaid / KanCare $3 - $7 95%
Medicare (plans) $3 - $6 95%
Health America Advantra $4 126%
UnitedHealthcare $5 - $36 158%
Ambetter / Centene $6 189%
Homestead Health Plans Woods Center $6 189%
Jefferson Health Plan Commercial $6 189%
Oscar $6 189%
Prime Healthcare $6 189%
Group Pension Administrators $7 221%
Keystone First $7 221%
Keystone First Chip $7 221%
Pace-Trinity Health $7 221%
Reedman Toll $7 221%
Blue Shield - Pa (Highmark) $9 284%
Amerihealth $15 473%
Blue Shield - Ca $15 473%
Blue Shield - Id (Regence) $15 473%
Blue Shield - Ny Highmark Western $15 473%
Blue Shield - Wa (Regence) $15 473%
Upmc Health Plan $17 536%
Webtpa $17 536%
Geha $30 946%
Meritain $66 2082%
Multiplan $67 2114%
Prime Health Services $67 2114%
Galaxy Health Network $70 2208%
Three Rivers Provider Network $70 2208%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals