CMS Price Transparency Data
Urinalysis (automated, with microscopy)
Facility: Watsonville Community Hospital
Billing Code: 81001 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 81001
- Insurance Median: $207
- Cash Discount Price: $225
- vs. Medicare Baseline: 65.30x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Watsonville Community Hospital is $207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 65.30x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$225
Average discount available for prompt cash payment at this facility.
Insurance Median
$207
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: $225 (7098%)
Insurance Median: $207 (6530%)
Cash: $225 (7098% of Medicare)
Ins. Median: $207 (6530% 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 6530% of the Medicare baseline (a markup of 6430%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Western Growers Work Comp | $3 | 95% |
| Secure Horizons Dign HMO | $3 - $75 | 95% |
| Alignment Health Plan | $3 | 95% |
| U.S. Dept. of Labor | $3 | 95% |
| Health Net of California | $3 - $235 | 95% |
| Pinnacle Healthcare Uc | $3 | 95% |
| Beta Healthcare Group | $3 | 95% |
| Tricare | $3 | 95% |
| Travelers Insurance | $3 - $375 | 95% |
| Gallagher Bassett Svcs | $3 | 95% |
| Liberty Mutual Work Comp | $3 | 95% |
| Nx Health Network | $3 | 95% |
| Miscellaneous Work Comp | $3 | 95% |
| Veterans Administration | $3 | 95% |
| Republic Idemnity W/Comp | $3 | 95% |
| Fireman's Fund Work Comp | $3 | 95% |
| Blue Shield PPO | $3 - $10 | 95% |
| Kemper Group Workers Comp | $3 | 95% |
| Keenan & Assoc Work Comp | $3 | 95% |
| Workers Comp | $3 | 95% |
| UnitedHealthcare | $3 - $225 | 95% |
| Medicare (plans) | $3 | 95% |
| Crawford & Co | $3 | 95% |
| Ace-Usa | $3 | 95% |
| Fleming & Associates | $3 | 95% |
| Hartford Workers' Comp | $3 | 95% |
| Secure Horizons | $3 | 95% |
| Medi-Cal/Eds | $4 | 126% |
| Ccs/Monterey County | $4 | 126% |
| Well Path | $4 - $375 | 126% |
| Medi-Cal E.R. | $4 | 126% |
| California Childrens Srvs | $4 | 126% |
| Healthy Families | $4 - $10 | 126% |
| Alliance/Sccho | $4 | 126% |
| Medicaid / KanCare | $4 | 126% |
| Ufcw/Valley Clerks | $10 | 315% |
| United Agriculture | $10 | 315% |
| Bs Employee | $10 | 315% |
| Aetna | $13 - $308 | 410% |
| Health Net Pmg HMO | $13 - $235 | 410% |
| Blue Cross Blue Shield | $13 - $334 | 410% |
| Blue Shield HMO | $13 - $75 | 410% |
| Cigna | $13 - $263 | 410% |
| Great-West/Phcs | $13 - $263 | 410% |
| Pacificare HMO | $13 - $225 | 410% |
| City of Wats/Pinnacle Clm | $20 - $334 | 631% |
| Teamsters Benefit Trust | $20 - $334 | 631% |
| Delta Health Systems | $20 - $334 | 631% |
| Monterey Bay Pub Emp Trst | $20 - $334 | 631% |
| Western Growers Trust/Bc | $20 - $334 | 631% |
| Laborers Health & Welfare | $20 - $334 | 631% |
| Calif Ironworkers Field | $20 - $334 | 631% |
| Claims Management Wc | $20 - $334 | 631% |
| Carpenters H&W Trust | $20 - $334 | 631% |
| Operating Engineers | $20 - $334 | 631% |
| Sheet Metal Workers | $20 - $334 | 631% |
| Robert Kennedy/Ccn | $20 - $334 | 631% |
| State Compensation Fund | $20 - $334 | 631% |
| Pinnacle Claims Tpa/Bc | $20 - $334 | 631% |
| Victim Compensation Plan | $68 - $375 | 2145% |
| Medicruz | $68 | 2145% |
| Western Health Advantage | $188 | 5931% |
| Self Pay | $225 | 7098% |
| Pacificare PPO | $225 | 7098% |
| Health Net Smartcare Netw | $225 | 7098% |
| Health Net Blue and Gold | $235 | 7413% |
| Health Net Canopycare HMO | $235 | 7413% |
| Adventist Risk Management | $263 - $300 | 8297% |
| First Health | $263 - $300 | 8297% |
| Transwestern | $263 - $300 | 8297% |
| Geha (Ccn) | $263 - $300 | 8297% |
| Multiplan Inc PPO | $293 | 9243% |
| Private Healthcare System | $293 | 9243% |
| Coastal Healthcare Admin | $319 - $338 | 10063% |
| Salinas Valley Mem Hops | $319 | 10063% |
| State Farm Ins | $375 | 11830% |
| Prucare Pmg POS | $375 | 11830% |
| North Calif Bakery Driver | $375 | 11830% |
| Aaa | $375 | 11830% |
| Humana | $375 | 11830% |
| Miscellaneous Insurance | $375 | 11830% |
| Miscellaneous Auto | $375 | 11830% |
| Physicians Mutual | $375 | 11830% |
| Bankers Life & Casualty | $375 | 11830% |
| Farmers Insurance | $375 | 11830% |
| Allstate | $375 | 11830% |
| Aarp | $375 | 11830% |
| Zenith National Ins | $375 | 11830% |
| Sutter Health Plus | $375 | 11830% |
| Prucare Pmg HMO | $375 | 11830% |
| Wholesale Beer Distributo | $375 | 11830% |
| Apwu Health Plan | $375 | 11830% |
| United Administrative | $375 | 11830% |