CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Geisinger Wyoming Valley Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $21
Cash Discount Price: $68
vs. Medicare Baseline: 6.62x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Geisinger Wyoming Valley Medical Center is $21. 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 6.62x the Medicare baseline. Located in 1000 East Mountain Boulevard, Wilkes Barre, PA.

Cash / Self-Pay

$68

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

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: $21 (662%)

Cash: $68 (2145% of Medicare)

Ins. Median: $21 (662% 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 662% of the Medicare baseline (a markup of 562%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$3	95%
Blue Cross Blue Shield	$3 - $25	95%
Geisinger Family Plan	$3	95%
Geisinger Health Plan	$3 - $10	95%
Humana	$3	95%
Life Geisinger	$3	95%
Medicaid / KanCare	$3	95%
Medicare (plans)	$3 - $4	95%
Prison Health Services	$3	95%
Health Partners	$4	126%
Upmc Chip	$4	126%
Upmc For You	$4	126%
Ambetter / Centene	$10	315%
Cigna	$47 - $49	1483%
Aetna	$51 - $73	1609%
Christian Healthcare Ministries	$54	1703%
UnitedHealthcare	$56	1767%
Wyoming Seminary	$76	2397%
Intergroup Services	$93	2934%
Multiplan	$93	2934%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $68.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 81001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Geisinger Wyoming Valley Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 81001.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.