Urinalysis (automated, with microscopy)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $5
- Cash Discount Price: $84
- vs. Medicare Baseline: 1.58x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Elara Caring Aspire Hospice [20433] | $3 | 95% |
| Medicare (plans) | $3 | 95% |
| Medica Contracted [320239] | $3 | 95% |
| Pace Of The Ozarks Contracted [320518] | $3 | 95% |
| Kindful Hospice Contracted [320434] | $3 | 95% |
| Blue Cross Blue Shield | $3 - $12 | 95% |
| UnitedHealthcare | $3 - $87 | 95% |
| Kindful Hospice [20434] | $3 | 95% |
| Medicaid / KanCare | $3 - $5 | 95% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $3 | 95% |
| Dept Of Veteran Affairs Contracted [320106] | $3 | 95% |
| Humana | $3 | 95% |
| Cross Timbers Hospice [20098] | $3 | 95% |
| Mercy Hospice Okc [20252] | $3 | 95% |
| Halo Hcr Inc Hospice [20432] | $3 | 95% |
| Aetna | $3 - $110 | 95% |
| Tricare | $3 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $3 | 95% |
| Health Choice Contracted [320166] | $4 | 126% |
| Home State Health Plan Contracted [320187] | $5 | 158% |
| Ambetter / Centene | $5 | 158% |
| Providrs Care Network Contracted [320484] | $6 | 189% |
| Cigna | $18 | 568% |
| United Medical Resources Contracted [320454] | $87 | 2744% |
| Healthlink Contracted [320179] | $103 | 3249% |
| Reflect Health Contracted [320492] | $103 | 3249% |
| Mercy Benefit Admin Contracted [320251] | $103 | 3249% |
| Aither Health Contracted [320449] | $103 | 3249% |
| Yuzu Health Contracted [320521] | $103 | 3249% |
| American Healthcare Alliance Contracted [320020] | $103 | 3249% |
| Ebms Contracted [320493] | $103 | 3249% |
| Auxiant Contracted [320462] | $103 | 3249% |
| Imagine 360 Contracted [320494] | $103 | 3249% |
| Edison Health Solutions Contracted [320502] | $103 | 3249% |
| Workers Comp [20426] | $103 | 3249% |
| First Health Contracted [320128] | $110 | 3470% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Mercy Hospital Pittsburg, Inc. lists a gross charge of $129.00, with a cash median of $84.00 and a negotiated median paid of $8.00. The facility's cash rate is significantly lower than the gross charge, and while specific state or county average data is not provided in this report, the facility's negotiated rate of $8.00 is notably lower than the Medicare amount of $3.17, suggesting a potential discrepancy or a specific payer contract structure. Patients should be aware that cash-pay options can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price. It is advisable to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can bypass administrative fees and reduce the final bill.
The price transparency data reveals a wide range of negotiated rates across different payers, with some commercial plans negotiating rates as high as $110.00, while others, such as Medicaid/KanCare and certain contracted entities, pay as low as $3.00 to $5.00. This variation highlights the importance of verifying your specific insurance plan's allowed amount, as in-network rates are not uniform and can vary significantly by carrier. To avoid unexpected costs, patients should request an itemized bill that details every CPT code and service rendered, as summary bills may obscure errors or unbundled charges. If a balance bill arises from an out-of-network service at an in-network facility, the