Urinalysis (automated, with microscopy)
Facility: Saint John Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $3
- Cash Discount Price: $3
- vs. Medicare Baseline: 0.95x 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 |
|---|---|---|
| Medicare (plans) | $3 | 95% |
| Medicaid / KanCare | $3 | 95% |
| Cigna | $3 | 95% |
| Celtic | $3 - $21 | 95% |
| Aetna | $3 - $6 | 95% |
| UnitedHealthcare | $3 - $4 | 95% |
| Midland Care Connection | $3 | 95% |
| Healthy Blue | $3 | 95% |
| Tricare | $3 | 95% |
| Kansas Superior Select | $3 | 95% |
| Well Path | $4 | 126% |
| Corizon | $4 | 126% |
| Employer Direct Healthcare | $4 | 126% |
| Blue Cross Blue Shield | $5 - $10 | 158% |
| Centurion | $5 | 158% |
| Naphcare | $5 | 158% |
| Comp Alliance Workers Comp | $6 | 189% |
| Oha Networks | $7 | 221% |
| Worker Compensation | $7 | 221% |
Consumer Guidance & Cost Commentary
For the automated urinalysis with microscopy (CPT 81001) at Saint John Hospital in Leavenworth, KS, the facility's cash median rate is $3.00, which is significantly lower than the state average of $29.00. While Medicare reimburses $3.17 for this service, commercial insurance negotiated rates vary widely among the 19 payers listed, ranging from $3.00 to $59.00 gross. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $3.00 rate is substantially lower than the average commercial negotiated amount. However, patients should verify if their specific insurance plan has a lower allowed amount before deciding to pay out-of-pocket, and they should inquire about "self-pay" or "prompt-pay" discounts at the time of registration to potentially reduce the final balance.
It is important to understand that the gross charge of $59.00 represents the full list price, which is often inflated to make discounts appear larger; the true benchmark for fair pricing is the Medicare rate of $3.17. If a patient receives care from an out-of-network provider or encounters services billed at the full chargemaster rate, they may face balance billing for the difference between the allowed amount and the full charge, though the No Surprises Act protects against this for emergency care and non-emergency services at in-network facilities. To avoid unexpected costs, patients should request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected through a formal