Urinalysis (automated, with microscopy)
Facility: Wesley Medical Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $7
- Cash Discount Price: $402
- vs. Medicare Baseline: 2.21x 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 221% of the Medicare baseline (a markup of 121%). 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 |
|---|---|---|
| Medicaid / KanCare | $3 | 95% |
| Humana | $3 | 95% |
| UnitedHealthcare | $3 | 95% |
| Devoted Health | $3 | 95% |
| Ambetter / Centene | $3 - $72 | 95% |
| Coventry Health Care | $3 | 95% |
| Amerigroup | $3 | 95% |
| United | $3 - $181 | 95% |
| Aetna | $3 - $144 | 95% |
| Triwest Health Alliance | $3 | 95% |
| Correct Care Solutions | $5 | 158% |
| First Health | $7 - $185 | 221% |
| Multiplan | $7 - $362 | 221% |
| Blue Cross Blue Shield | $10 | 315% |
| Wppa | $70 | 2208% |
| Health Partners Of Kansas | $70 - $201 | 2208% |
| Medical Associates Health Plan | $76 | 2397% |
| Preferred Health Choices | $76 | 2397% |
| Spirit Aerosystems | $129 | 4069% |
| Triwest Healthcare Alliance | $261 | 8233% |
| Usa Managed Care | $342 | 10789% |
Consumer Guidance & Cost Commentary
For the automated urinalysis with microscopy (CPT 81001) at Wesley Medical Center in Wichita, KS, the cash price is $402.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average, reflecting a markup of 220% compared to the Medicare benchmark of $3.17. While commercial insurance plans like Humana and UnitedHealthcare negotiate contracts that cap charges, these negotiated rates often include administrative overhead and can exceed the cash price for patients with high deductibles. Because the cash price is already at the median paid level, patients with active insurance coverage may not realize additional savings by using their plans, as the insurer's allowed amount could be higher than the direct cash rate.
Patients should verify their specific plan's negotiated rate before scheduling, as in-network contracts vary widely and some may result in higher out-of-pocket costs than paying cash outright. If you have a high-deductible plan, paying the $402.00 cash price upfront might be more cost-effective than waiting for insurance to cover the service, especially if the insurer's allowed amount exceeds the cash price. Additionally, you can request a prompt-pay discount from the billing department to potentially lower the final amount owed, as hospitals often offer fee reductions for upfront payment to bypass administrative processing costs. Always ensure you sign a waiver of insurance submission if you choose to pay cash directly to avoid automatic claims that could void any agreed-upon discounts.