Urinalysis at St. Luke's Jerome Standard Charges. CPT 81001.
What St. Luke's Jerome Standard Charges publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$14.00cash price (self-pay)
$14.00list price
$3.17–$13.30range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Mv Slhp St Lukes | $3.17 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Carepoint Qhp | $3.17 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Large Group | $3.17 |
| Commercial [1028] | Hb Mv Slhp Mountain Health Coop | $3.17 |
| Commercial [1028] | Hb Mv Slhp Select Health | $3.17 |
| Commercial [1028] | Hb Mv Slhp Select Health Qhp | $3.17 |
| Commercial [1028] | Hb Mv Va Ccn | $3.17 |
| Medicare Advantage Generic [1019] | Hb Mv Medicare Advantage | $3.17 |
| Medicare Advantage Generic [1019] | Hb Mv Molina Mmcp | $3.17 |
| Medicare Advantage Molina [1053] | Hb Mv Molina Mmcp | $3.17 |
| Medicare Advantage Pacificsource [1039] | Hb Mv Pacificsource HMO PPO | $3.17 |
| Medicare Advantage Pacificsource [1039] | Hb Mv Slhp Pacificsource Med | $3.17 |
| Medicare Advantage Regence [1016] | Hb Mv Medicare Advantage | $3.17 |
| Blue Cross/Medicare Advantage [1009] | Hb Mv Bci True & Secure Med Adv | $3.20 |
| Medicare Advantage Generic [1019] | Hb Mv Molina Med Adv | $3.23 |
| Medicare Advantage Molina [1053] | Hb Mv Molina Med Adv | $3.23 |
| Medicare Advantage Aetna [1017] | Hb Mv Aetna Med Adv | $3.49 |
| Blue Cross Out Of State [1041] | Hb Mv Bci Out Of State | $7.13 |
| Blue Shield Alt [100401] | Hb Mv Regence Out Of State | $7.13 |
| Commercial [1028] | Hb Mv Regence PPO & Traditional | $7.13 |
| Commercial [1028] | Hb Mv H2b | $10.50 |
| H2b [1068] | Hb Mv H2b | $10.50 |
| Aetna [1021] | Hb Mv Bp Aetna | $11.20 |
| Cigna [1062] | Hb Mv Cigna | $11.20 |
| Commercial [1028] | Hb Mv Bp Aetna | $11.20 |
| Commercial [1028] | Hb Mv Cigna | $11.20 |
| Commercial [1028] | Hb Mv Multiplan Primary Network | $11.20 |
| Commercial [1028] | Hb Mv Amps | $11.90 |
| Commercial [1028] | Hb Mv Christian Health Aid | $11.90 |
| Commercial [1028] | Hb Mv First Choice Health | $11.90 |
Inpatient
$24.00cash price (self-pay)
$24.00list price
$15.60–$22.80range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Mv Slhp St Lukes | $15.60 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Carepoint Qhp | $15.60 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Large Group | $15.60 |
| Commercial [1028] | Hb Mv Slhp Mountain Health Coop | $15.60 |
| Commercial [1028] | Hb Mv Slhp Select Health | $15.60 |
| Commercial [1028] | Hb Mv Slhp Select Health Qhp | $15.60 |
| Medicare Advantage Pacificsource [1039] | Hb Mv Slhp Pacificsource Med | $15.60 |
| Mountain Health Co-Op [1067] | Hb Mv Slhp Mountain Health Coop | $15.60 |
| Pacificsource [1020] | Hb Mv Pacificsource Navigator Large Group | $15.60 |
| Pacificsource [1020] | Hb Mv Slhp Pacificsource Navigator Qhp | $15.60 |
| Select Health [1063] | Hb Mv Slhp Select Health | $15.60 |
| Select Health [1063] | Hb Mv Slhp Select Health Qhp | $15.60 |
| St Lukes Health Plan [1046] | Hb Mv Slhp St Lukes Health Plan Large Gr | $15.60 |
| St Lukes Health Plan [1046] | Hb Mv Slhp St Lukes Health Plan Qhp | $15.60 |
| Commercial [1028] | Hb Mv H2b | $18.00 |
| H2b [1068] | Hb Mv H2b | $18.00 |
| Pacificsource [1020] | Hb Mv Pacificsource PPO Voyager | $18.00 |
| Aetna [1021] | Hb Mv Bp Aetna | $19.20 |
| Cigna [1062] | Hb Mv Cigna | $19.20 |
| Commercial [1028] | Hb Mv Bp Aetna | $19.20 |
| Commercial [1028] | Hb Mv Cigna | $19.20 |
| Commercial [1028] | Hb Mv Multiplan Primary Network | $19.20 |
| Commercial [1028] | Hb Mv Va Ccn | $19.20 |
| Providence [1022] | Hb Mv Cigna | $19.20 |
| Commercial [1028] | Hb Mv Amps | $20.40 |
| Commercial [1028] | Hb Mv Christian Health Aid | $20.40 |
| Commercial [1028] | Hb Mv First Choice Health | $20.40 |
| First Health [1064] | Hb Mv First Choice Health | $20.40 |
| Blue Cross Federal [1008] | Hb Mv Bci PPO Fep | $20.52 |
| Blue Cross Idaho [1007] | Hb Mv Bci PPO Fep | $20.52 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.