CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Astria Sunnyside Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $59
Cash Discount Price: $48
vs. Medicare Baseline: 18.61x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Astria Sunnyside Hospital is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 18.61x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $48 (1514%)

Insurance Median: $59 (1861%)

Cash: $48 (1514% of Medicare)

Ins. Median: $59 (1861% 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 1861% of the Medicare baseline (a markup of 1761%). 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
Aetna	$3 - $156	95%
Healthcomp_Ihs	$3	95%
Humana	$3 - $159	95%
Medicare (plans)	$3	95%
Tricare	$3	95%
Va	$3	95%
Medicaid / KanCare	$16 - $54	505%
Molina	$16 - $43	505%
Regence	$34 - $91	1073%
Cigna	$40 - $106	1262%
Li	$41 - $109	1293%
First_Choice	$50 - $133	1577%
Tpsc	$52 - $138	1640%
Kaiser	$53 - $139	1672%
Premera	$55 - $144	1735%
UnitedHealthcare	$57 - $150	1798%
Fhpw	$59 - $156	1861%
Healthcomp	$60 - $159	1893%
Bcchp	$67 - $177	2114%
Great_Rivers	$67 - $177	2114%
Zenith	$67 - $177	2114%

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 $48.
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 Astria Sunnyside 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.