CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Baylor Scott & White Medical Center Hillcrest

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $29
Cash Discount Price: $72
vs. Medicare Baseline: 9.15x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Baylor Scott & White Medical Center Hillcrest is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 9.15x the Medicare baseline. Located in 100 Hillcrest Medical Blvd, Waco, TX.

Cash / Self-Pay

$72

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: $72 (2271%)

Insurance Median: $29 (915%)

Cash: $72 (2271% 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.

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
American Health Plan	$3	95%
Baylor Scott & White Health Plan	$3 - $51	95%
Blue Cross Blue Shield	$3 - $19	95%
Corvel	$3	95%
Humana	$3 - $84	95%
Prime Health Services	$3	95%
Procare Advantage	$3	95%
Triwest	$3	95%
Injury Management Organization	$4	126%
UnitedHealthcare	$4 - $5	126%
Sedgwick	$5	158%
Superior Health Plan	$14	442%
Texas Workforce Commission	$40	1262%
Cigna	$62 - $72	1956%
Aetna	$66	2082%
Midcoast	$66	2082%
Quiktrip	$66	2082%
University Of Mary Hardin-Baylor	$70	2208%
Independent Medical System	$72	2271%
Imagine Health	$75	2366%
Curative	$78	2461%
First Health	$84	2650%
Healthsmart	$84 - $90	2650%
Private Health Care System	$90	2839%

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 $72.
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 Baylor Scott & White Medical Center Hillcrest 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.