CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Dominion Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $51
  • Cash Discount Price: $108
  • vs. Medicare Baseline: 16.09x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Dominion Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 16.09x the Medicare baseline. Located in 2960 Sleepy Hollow Road, Falls Church, VA.
Cash / Self-Pay
$108

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

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: $108 (3407%)
Insurance Median: $51 (1609%)
Cash: $108 (3407% of Medicare)
Ins. Median: $51 (1609% 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 1609% of the Medicare baseline (a markup of 1509%). 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
Align Senior Care $3 95%
Cigna $3 95%
Clear Spring Health Plan $3 95%
Davita Village Health $3 95%
Devoted $3 95%
Humana $3 95%
Johns Hopkins $3 95%
Pyramid Life $3 95%
United Behavioral Health $3 95%
Virginia Premier Health $3 95%
Managed Health Network $4 126%
Carefirst $51 - $54 1609%
Aetna $65 2050%
Greenvbrier Sporting Club $65 2050%
Value Options $65 2050%
Virginia Health Network $77 2429%
Corvel $78 2461%
Phcs $81 2555%
4Most Health Network $98 3091%
Multiplan $98 3091%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2960 Sleepy Hollow Road, Falls Church, VA 22044
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Psychiatric