Urinalysis (automated, with microscopy)
Facility: Pratt Regional Medical Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $42
- Cash Discount Price: $34
- vs. Medicare Baseline: 13.25x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 1325% of the Medicare baseline (a markup of 1225%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Christian Health Aid | $36 | 1136% |
| UnitedHealthcare | $40 - $49 | 1262% |
| Health Partners Of Kansas | $41 | 1293% |
| Aetna | $43 | 1356% |
| Choicecare | $48 | 1514% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, "Urinalysis (automated, with microscopy)," Pratt Regional Medical Center in Pratt, KS, lists a cash median price of $34.00, which is notably lower than the facility's gross charge of $48.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $40.00 to $49.00, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying cash directly. It is important to note that commercial insurance rates are frequently inflated by administrative costs and contract dynamics, sometimes reaching 200% to 300% of the Medicare benchmark of $3.17, whereas fair pricing is typically defined as 120% to 150% of this baseline. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting the deductible can result in significantly higher out-of-pocket costs compared to the cash option.
To ensure you are not overcharged, always request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a summary bill showing only broad categories, demand a detailed line-by-line statement to identify any services not rendered or charges that should be bundled. Additionally, be aware of the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities; if you encounter a surprise bill, dispute it immediately with your insurer rather than paying it out of fear