CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Marshfield Medical Center

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $71
Cash Discount Price: $80
vs. Medicare Baseline: 22.40x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Marshfield Medical Center is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 22.40x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $80 (2524%)

Insurance Median: $71 (2240%)

Cash: $80 (2524% of Medicare)

Ins. Median: $71 (2240% 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 2240% of the Medicare baseline (a markup of 2140%). 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
Blue Cross Blue Shield	$3 - $20	95%
Group Health Cooperative Of Eau Claire	$3 - $77	95%
Security Health Plan (Shp)	$3 - $22	95%
Veteran'S Administration (Va Ccn)	$3	95%
Managed Health Services	$4	126%
UnitedHealthcare	$11	347%
Family Health Center (Fhc)	$42	1325%
Amish/Mennonite	$46	1451%
Sanford Health Plan	$46	1451%
The Alliance	$58 - $70	1830%
Besse Forest Products	$71	2240%
Molina Healthcare Of Wi	$71	2240%
Rice Lake School District	$71	2240%
Wps Health Insurance	$74 - $81	2334%
Trilogy	$76 - $81	2397%
Medica Of Wi	$78 - $80	2461%
Cigna	$79	2492%
Healtheos By Multiplan Inc.	$79 - $80	2492%
Corvel	$80	2524%
First Health	$80	2524%
Health Partners	$80	2524%
Three Rivers Provider Network (Trpn)	$80	2524%
Coventry	$81	2555%
Health Smart	$81	2555%
Rising Medical Work Comp	$81	2555%

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 $80.
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 Marshfield 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.