CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Kona Community Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $4
Cash Discount Price: $34
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Kona Community Hospital is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 1.26x the Medicare baseline. Located in 79-1019 Haukapila Street, Kealakekua, HI.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $34 (1073%)

Insurance Median: $4 (126%)

Cash: $34 (1073% of Medicare)

Ins. Median: $4 (126% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Alohacare	$3	95%
Hmsa	$3 - $8	95%
Humana	$3	95%
Kaiser	$3	95%
Ohana	$3 - $4	95%
UnitedHealthcare	$3 - $4	95%
Hma	$8	252%
Uha	$8	252%
Hmaa	$9	284%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $34.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 81001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Kona Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 81001.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.