CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Decatur County Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $46
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 14.51x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Decatur County Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 14.51x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $46 (1451%)
Insurance Median: $46 (1451%)
Cash: $46 (1451% of Medicare)
Ins. Median: $46 (1451% 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 1451% of the Medicare baseline (a markup of 1351%). 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.

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
UnitedHealthcare $2 - $49 63%
Blue Cross Blue Shield $19 599%
Wellmark Hmo $22 694%
Wellmark Ppo - All Other Plans $25 789%
Champva -All Plans $26 820%
Everystep Hospice-All Plans $30 946%
Aetna $31 - $46 978%
Tricare $31 978%
Benefit Admin System-All Plans $38 1199%
Humana $42 1325%
Meritain Health-All Plans $42 1325%
Misc Commercial-All Plans $42 1325%
All Savers-All Plans $44 1388%
Allied Benefit System-All Plans $44 1388%
American Family Ins Grp-All Plans $44 1388%
Rural Carrier Benefit Plan-All Plans $45 1420%
Christian Healthcare -All Plans $46 1451%
Medica-All Other Plans $46 1451%
Golden Rule-All Plans $49 1546%
Ntca The Rural Broadband-All Plans $49 1546%
Cigna $50 1577%
Medical Mutual-All Plans $51 1609%
Farm Bureau Financial-All Other Plans $52 1640%
Farm Bureau Property And Ca $52 1640%
Health Partners-All Plans $53 1672%
Medi Share-All Plans $53 1672%
Uhss-All Plans $53 1672%
Lewermark-All Plans $55 1735%
Mail Handlers Benefit-All Plans $57 1798%
Midlands Choice-All Plans $57 1798%
Priority Health-All Plans $58 1830%
Iowa Total Care Mcaid-All Plans $59 1861%
Amerigroup Mcaid-All Plans $61 1924%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals