Urinalysis (automated, with microscopy)
Facility: Mcpherson Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $70
- Cash Discount Price: $68
- vs. Medicare Baseline: 22.08x 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 2208% of the Medicare baseline (a markup of 2108%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $3 | 95% |
| Wellcare Mcr Adv - All Plans | $3 | 95% |
| Healthy Blue Mcr Adv | $3 | 95% |
| Va Ccn - All Plans | $3 | 95% |
| UnitedHealthcare | $3 - $109 | 95% |
| Tricare | $3 | 95% |
| Humana | $3 | 95% |
| Ambetter / Centene | $4 | 126% |
| Wppa - All Plans | $18 - $76 | 568% |
| Medical Associates - All Plans | $19 - $82 | 599% |
| Central Plains - All Plans | $19 - $82 | 599% |
| Christian Health Aid - All Plans | $20 - $87 | 631% |
| Aetna | $21 - $109 | 662% |
| Multiplan - All Plans | $22 - $98 | 694% |
| Cigna | $24 - $104 | 757% |
| Health Partners - All Plans | $24 - $104 | 757% |
| First Health - All Plans | $24 - $104 | 757% |
| Medicaid / KanCare | $25 - $109 | 789% |
| Health Blue Mcaid - All Other Plans | $26 - $111 | 820% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), McPherson Hospital in Kansas charges a cash median of $68.00, which is lower than the facility's negotiated median paid rate of $73.00. This service is covered by 19 payers, including UnitedHealthcare and Aetna, with negotiated rates ranging from $3.00 to $111.00 depending on the plan. When comparing pricing benchmarks, the facility's cash rate is significantly lower than the Medicare amount of $3.17, though the provided "vs_medicare" metric of 22.1% likely reflects a specific calculation method relative to the gross charge rather than a direct ratio. Patients should note that while cash-pay rates are often the most affordable option, some commercial plans may negotiate rates that exceed the cash price; therefore, verifying your specific plan's allowed amount before scheduling is essential to avoid unexpected costs.
To ensure you receive the most accurate billing information, we recommend requesting a full itemized bill rather than accepting a summary invoice, as hospitals may obscure individual line items to hide errors or unbundled charges. If you choose to pay out-of-pocket, ask about prompt-pay discounts, which can reduce the total by 20% to 50% if settled within 30 days, effectively bypassing costly administrative processing fees. Additionally, be aware that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to confirm that all ancillary services, such as specific lab components, are covered under your plan to prevent surprise charges. Always contact the hospital