CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: University Of Kansas Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $12
  • Cash Discount Price: $4
  • vs. Medicare Baseline: 3.79x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at University Of Kansas Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 3.79x the Medicare baseline. Located in 4000 Cambridge Street, Kansas City, KS.
Cash / Self-Pay
$4

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $4 (126%)
Insurance Median: $12 (379%)
Cash: $4 (126% of Medicare)
Ins. Median: $12 (379% 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 379% of the Medicare baseline (a markup of 279%). 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
Larned State Hospital [503200090] $5 - $6 158%
Accarent Health [503999034] $8 - $10 252%
Alt Carelon Behavioral Health [503200905] $8 - $10 252%
Health Plan Inc [503999941] $8 - $9 252%
Php [503200005] $10 - $14 315%
Alt Wppa [5032000964] $10 - $12 315%
Inter-Americas Insurance [503999032] $10 - $12 315%
Geha [503200036] $10 - $12 315%
Healthlink [503200007] $10 - $14 315%
Allied National [503999937] $10 - $11 315%
Cigna $10 - $15 315%
Cerner [503200038] $10 - $12 315%
Med-Pay [503200040] $10 - $12 315%
Coeur Plan Services [503301517] $11 - $13 347%
Blue Cross Blue Shield $11 - $15 347%
Ascension Living Hope [503201517] $11 - $13 347%
Correct Care Solutions [50311253] $11 - $13 347%
Aha-Healthcare Preferred [503200050] $11 - $13 347%
First Health [5032000110] $11 - $13 347%
Consolidated Billing [50311256] $11 - $13 347%
Orscheln Industries [503201608] $12 - $14 379%
Alt Lineco [5032000976] $12 - $15 379%
Empire Plan/Nyship [503200705] $12 - $15 379%
Alt Lucent Health Solutions [503202603] $12 - $15 379%
Meritain Health [503200039] $13 - $16 410%
Point Comfort Underwriters [503200018] $13 - $15 410%
Quiktrip [5032000412] $13 - $15 410%
Century Health Solutions [503200054] $13 - $15 410%
Wppa [503200056] $13 - $16 410%
Sanford Health Plan [503999027] $14 - $17 442%
Usa Managed Care [503999030] $14 - $17 442%
Three Rivers Provider Network [503999029] $14 - $17 442%
Plan Care America [503999026] $14 - $17 442%
Employers Health Network [503999025] $14 - $17 442%
Workers Comp [503999901] $15 - $82 473%

Consumer Guidance & Cost Commentary

For the automated urinalysis with microscopy service at University Of Kansas Hospital, the negotiated rates for in-network payers range from $5 to $82, with most commercial plans falling between $10 and $17. This is notably higher than the facility's cash price of $4.00 and the Medicare benchmark of $3.17. While many insurance plans negotiate rates that exceed the cash amount, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance allowed amount often surpasses the self-pay rate. It is important to note that the facility is a government-owned acute care hospital in Kansas City, KS, and while the facility holds a 5-star rating, the significant gap between cash and negotiated rates suggests that paying out-of-pocket could result in substantial savings compared to standard insurance billing.

Patients should be aware that insurance billing processes can sometimes lead to unexpected costs if not managed carefully. Although the No Surprises Act protects against balance billing for emergency services at in-network facilities, it is crucial to verify your specific plan's deductible status before scheduling, as you may be responsible for the full negotiated rate if your deductible has not been met. To minimize costs, we strongly recommend asking the hospital about "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, and requesting an itemized bill to ensure no errors or unbundled charges are included. Always confirm whether your specific procedure is classified as self-pay prior to check-in to avoid automatic claims submission, which could void any potential cash discounts.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4000 Cambridge Street, Kansas City, KS 66160
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals