CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Prosser Memorial Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $90
Cash Discount Price: $63
vs. Medicare Baseline: 28.39x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Prosser Memorial Hospital is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 28.39x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$63

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $63 (1987%)

Insurance Median: $90 (2839%)

Cash: $63 (1987% of Medicare)

Ins. Median: $90 (2839% 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 2839% of the Medicare baseline (a markup of 2739%). 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
UnitedHealthcare	$5 - $47	158%
Kaiser Permanente	$23 - $106	726%
Community Health Plan Of Washington	$24 - $47	757%
Coordinated Care	$24 - $47	757%
Molina	$25 - $47	789%
Amerigroup	$26 - $50	820%
Health Alliance Northwest	$28 - $29	883%
Wellcare	$28 - $29	883%
Humana	$29 - $99	915%
Aetna	$34 - $99	1073%
Ambetter / Centene	$79 - $89	2492%
Asuris	$90 - $104	2839%
Health Management Adminstrators	$90 - $104	2839%
Premera	$90 - $93	2839%
Regence	$90 - $104	2839%
Cigna	$93 - $95	2934%
First Choice	$96 - $99	3028%
Multiplan	$96 - $104	3028%

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 $63.
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 Prosser Memorial Hospital 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.