Urinalysis (automated, with microscopy)
Facility: Providence Medical Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $3
- Cash Discount Price: $3
- 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 |
|---|---|---|
| Medicaid / KanCare | $3 | 95% |
| Celtic | $3 - $5 | 95% |
| Aetna | $3 - $6 | 95% |
| Cigna | $3 | 95% |
| Healthy Blue | $3 | 95% |
| Medicare (plans) | $3 | 95% |
| Kansas Superior Select | $3 | 95% |
| UnitedHealthcare | $3 - $5 | 95% |
| Tricare | $3 | 95% |
| Blue Cross Blue Shield | $3 - $8 | 95% |
| Midland Care Connection | $3 | 95% |
| Employer Direct Healthcare | $4 | 126% |
| Corizon | $4 | 126% |
| Well Path Prison | $4 | 126% |
| Centurion | $5 | 158% |
| Naphcare | $5 | 158% |
| Comp Alliance - Fka Compresults Worker Compensation | $6 | 189% |
| Oha Networks | $7 | 221% |
| Worker Compensation | $7 | 221% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), the gross charge at Providence Medical Center in Kansas City, KS is $59.00. While the facility's cash median is $3.00 and the median negotiated rate across payers is also $3.00, the Medicare amount is $3.17. The facility's cash price is significantly lower than the Medicare benchmark, which serves as a reliable baseline for fair pricing. Patients with high-deductible plans may find that paying the cash price of $3.00 upfront is more cost-effective than relying on insurance, as the negotiated rates often exceed the cash rate. It is important to note that while the cash price is low, the gross charge of $59.00 represents the full list price before any discounts are applied.
The data indicates that this service is covered by 19 different payers, including Medicaid/KanCare, Medicare, and various commercial insurers like UnitedHealthcare and Aetna. The facility is a voluntary non-profit acute care hospital located in Kansas City with a facility rating of 3. When reviewing your specific bill, ensure you are looking at an itemized statement rather than a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a balance bill for the difference between the provider's charge and your insurance allowed amount, you may have protections under the No Surprises Act, particularly if the care was emergency or non-emergency at an in-network facility. Always request a prompt-pay discount before scheduling, as paying in full upfront can reduce the final amount owed by 2