Urinalysis at Good Samaritan Hospital. CPT 81001.
What Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated June 29, 2026.
Outpatient / ER
$51.00cash price (self-pay)
$51.00list price
$3.17–$149range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Beacon Medicare | Beacon Medicare | $3.17 |
| Hamaspik (Mcr) | Hamaspik (Mcr) | $3.17 |
| Medicare | Medicare | $3.17 |
| Medicare Managed | Medicare Managed | $3.17 |
| Mvp Gold (Mcr) | Mvp Gold (Mcr) | $3.17 |
| Emblem Ghi/Hip Medicare | Emblem Ghi/Hip Medicare | $3.23 |
| Affinity By Molina Mcr | Affinity By Molina Mcr | $3.33 |
| Health First Medicare | Health First Medicare | $3.39 |
| Beacon Exchange | Beacon Exchange | $3.80 |
| Tricare | Tricare | $3.92 |
| Beacon Commercial | Beacon Commercial | $4.12 |
| Aetna HP Network | Aetna HP Network | $5.52 |
| Aetna | Aetna | $6.12 |
| Aetna Employee | Aetna Employee | $6.12 |
| Emblem Select Care (Exchange) | Emblem Select Care (Exchange) | $7.96 |
| Emblem Ghi/Hip PPO | Emblem Ghi/Hip PPO | $9.35 |
| Geisinger Health Commercial/Exchange | Geisinger Health Commercial/Exc | $10.46 |
| Magnacare Preferred | Magnacare Preferred | $12.52 |
| Mvp Exchange | Mvp Exchange | $13.72 |
| SELF-PAY - CC 30% | SELF-PAY - CC 30 PerCent | $15.30 |
| Blue Cross Connection/Exchange | Blue Cross Connection/Exchange | $24.16 |
| Cdphp | Cdphp | $25.50 |
| Oxford Exchange | Oxford Exchange | $25.50 |
| Self-Pay - Cc 50% | Self-Pay - Cc 50 | $25.50 |
| Mvp HMO/PPO | Mvp HMO/PPO | $26.68 |
| Self-Pay | Self-Pay | $26.74 |
| Blue Cross Small Group | Blue Cross Small Group | $29.01 |
| Blue Cross HMO | Blue Cross HMO | $29.82 |
| Cigna PPO | Cigna PPO | $35.70 |
| Magnacare Standard | Magnacare Standard | $35.70 |
Inpatient
$51.00cash price (self-pay)
$51.00list price
$15.30–$35.70range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| SELF-PAY - CC 30% | SELF-PAY - CC 30 PerCent | $15.30 |
| Cdphp | Cdphp | $25.50 |
| Self-Pay - Cc 50% | Self-Pay - Cc 50 | $25.50 |
| Magnacare Standard | Magnacare Standard | $35.70 |
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