CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Childrens Hospital of Wisconsin

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $66
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 20.82x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Childrens Hospital of Wisconsin is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 20.82x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $47 (1483%)
Insurance Median: $66 (2082%)
Cash: $47 (1483% of Medicare)
Ins. Median: $66 (2082% 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 2082% of the Medicare baseline (a markup of 1982%). 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
Chorus Community Health Plan $3 95%
Managed Health Services $3 95%
My Choice Wisconsin $3 - $4 95%
UnitedHealthcare $3 - $75 95%
Blue Cross Blue Shield $4 - $94 126%
Icare $4 126%
Molina Healthcare Of Wisconsin $4 126%
Froedtert Health $51 - $84 1609%
Medical College Of Wisconsin $51 - $69 1609%
Network Health Plan $52 - $70 1640%
Aspirus Health Plan $55 - $74 1735%
Common Ground Healthcare Cooperative $55 - $84 1735%
Trilogy Health Solutions $55 - $84 1735%
Wps Health Plan $55 - $89 1735%
Advocate Aurora Healthcare $56 - $76 1767%
Centivo $57 - $77 1798%
Employer Health Care Alliance Cooperative $57 - $77 1798%
Health Partners $57 - $87 1798%
Dean Health Plan $58 - $79 1830%
Group Health Cooperative Of Eau Claire $58 - $79 1830%
Oan Llc $58 - $79 1830%
Security Health Plan $61 - $82 1924%
Health Payment Systems $62 - $83 1956%
Praire States $62 - $84 1956%
Quartz Health Insurance $62 - $84 1956%
Sheboygan Employer'S Health Network $62 - $84 1956%
Aetna $64 - $88 2019%
Mayo Clinic Health Solutions $64 - $86 2019%
Bellin Thedacare $66 - $89 2082%
Cigna $66 - $89 2082%
Group Health Cooperative Of South Central Wisconsin $66 - $89 2082%
Multiplan $66 - $94 2082%
Prevea Health Network $66 - $89 2082%
Coventry Health Care $69 - $94 2177%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens