CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Vandalia Health Broaddus Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $50
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 15.77x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Vandalia Health Broaddus Hospital is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 15.77x the Medicare baseline. Located in 1 Healthcare Drive Mansfield Hill, Philippi, WV.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $39 (1230%)
Insurance Median: $50 (1577%)
Cash: $39 (1230% of Medicare)
Ins. Median: $50 (1577% 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 1577% of the Medicare baseline (a markup of 1477%). 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
Aetna $3 - $50 95%
Blue Cross Blue Shield $6 - $40 189%
Peak Health $10 - $18 315%
Highmark $41 1293%
The Health Plan $41 - $50 1293%
UnitedHealthcare $41 - $54 1293%
Humana $43 1356%
West Virginia Senior Advantage $44 1388%
Cigna $49 1546%
First Health $50 1577%
Geisenger Health Plan $52 1640%
Health Network America $52 - $53 1640%
Geha $53 1672%
Multiplan/Phcs $53 1672%
Selectnet $55 1735%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Healthcare Drive Mansfield Hill, Philippi, WV 26416
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals