Urinalysis (automated, with microscopy)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $3
- Cash Discount Price: $57
- 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 |
|---|---|---|
| Providrs Care | $3 | 95% |
| UnitedHealthcare | $3 - $9 | 95% |
| Smarthealth | $3 - $4 | 95% |
| Aetna | $3 | 95% |
| Medicare (plans) | $3 | 95% |
| Humana | $3 | 95% |
| Medicaid / KanCare | $3 | 95% |
| Va | $3 | 95% |
| Ambetter / Centene | $5 | 158% |
| Blue Cross Blue Shield | $47 - $128 | 1483% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Ascension Via Christi Hospital Manhattan, Inc. lists a cash median price of $57.00, which is significantly lower than the facility's gross charge of $142.00. While the data does not provide specific state or county average figures for this procedure, patients should be aware that cash-pay rates can sometimes be more affordable than insurance negotiated rates, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price. To secure the lowest possible cost, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the bill by offering immediate liquidity incentives.
Insurance coverage for this service is available through ten payers, including UnitedHealthcare, Aetna, and Medicare, with negotiated rates ranging from $3.00 to $128.00 depending on the specific plan. Notably, the median negotiated rate of $3.00 is substantially lower than the cash price, suggesting that for most insured patients, using their coverage will result in a much lower out-of-pocket expense than paying cash. However, patients must be cautious of balance billing if they receive out-of-network services, such as emergency care or ancillary lab tests, where the provider may bill the difference between the contract rate and the chargemaster. If a surprise bill arises, consumers should verify its legality under the No Surprises Act and request a formal itemized audit to identify any unbundled codes or services not rendered before agreeing to payment.