Urinalysis at Good Samaritan Hospital (GSH). CPT 81001.
What Good Samaritan Hospital (GSH) publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$211cash price (self-pay)
$352list price
$2.35–$352range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Advantage | $3.17 |
| Allwell | MCR ADV/PPO/HMO | $3.17 |
| Anthem HIP | HIP | $3.17 |
| Anthem MCR | MCR ADV/PPO/HMO | $3.17 |
| Anthem MCR | Medicare Advantage | $3.17 |
| Anthem | MCR ADV/PPO/HMO | $3.17 |
| Anthem | Medicaid | $3.17 |
| BCBS | Medicare Advantage | $3.17 |
| Caresource HIP | Medicaid | $3.17 |
| Caresource | Medicaid | $3.17 |
| Cigna | Medicare Advantage | $3.17 |
| Humana | Medicare Advantage | $3.17 |
| United Healthcare | Medicare Advantage | $3.17 |
| Aetna | Medicaid | $3.17 |
| Anthem Pathways | Medicaid | $3.17 |
| Indiana University | MCR ADV/PPO/HMO | $3.17 |
| MHS Ambetter | Commercial | $3.17 |
| Alliance Coal | Commercial | $3.96 |
| CareSource | Commercial | $4.36 |
| Encore Prime | Commercial | $4.78 |
| Aetna | Commercial | $5.32 |
| Hope Trust | Commercial | $6.34 |
| Anthem | Trad/PPO/HMO | $127 |
| OneCare | Commercial | $136 |
| Direct Health | Direct Health | $137 |
| Anthem | HealthSync | $153 |
| HealthLink | HMO | $159 |
| HealthLink | PPO | $168 |
| Amish | Commercial | $176 |
| Anthem | Exchange | $201 |
Inpatient
$211cash price (self-pay)
$352list price
$205–$352range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Exchange | $205 |
| United Healthcare | Commercial | $233 |
| Anthem | Trad/PPO/HMO | $256 |
| Direct Health | Direct Health | $270 |
| SIHO | Commercial | $270 |
| Cigna | Commercial | $278 |
| Sagamore | Commercial | $278 |
| Corvel | Workers Comp | $289 |
| Aetna | Commercial | $295 |
| Anthem | HealthSync | $303 |
| HealthLink | HMO | $310 |
| Encore Prime | Commercial | $317 |
| Humana | Commercial | $317 |
| HealthLink | PPO | $327 |
| Molina | Medicaid | $352 |
| Underwriters Safety | Commercial | $352 |
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