Urinalysis (automated, with microscopy)
Facility: Centura St. Catherine-Dodge City
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $166
- Cash Discount Price: $101
- vs. Medicare Baseline: 52.37x 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 5237% of the Medicare baseline (a markup of 5137%). 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 - $11 | 95% |
| Kansas Health | $3 | 95% |
| Kaiser | $3 | 95% |
| Medicare (plans) | $3 | 95% |
| Humana | $3 | 95% |
| Cigna | $3 | 95% |
| Aetna | $3 - $202 | 95% |
| Centura Employee Plan | $4 | 126% |
| UnitedHealthcare | $166 | 5237% |
| Wpaa | $177 | 5584% |
| Multiplan | $202 - $227 | 6372% |
| Christian Health Aid | $202 | 6372% |
| Health Partners Of Kansas | $227 | 7161% |
Consumer Guidance & Cost Commentary
For the automated urinalysis with microscopy (CPT 81001) at Centura St. Catherine-Dodge City, the cash median price is $101.00, which is significantly lower than the state average of $166.00 and the facility's own negotiated rate of $166.00. While many commercial payers like Blue Cross Blue Shield and Humana have negotiated rates starting around $3.00, these figures likely represent the patient's out-of-pocket responsibility after deductibles and co-pays rather than the total allowed amount. Because commercial negotiated rates often include administrative overhead and can exceed cash prices, patients with high-deductible plans may find paying the $101.00 cash median directly more cost-effective than relying on insurance, provided they verify their specific plan's allowed amount.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Additionally, you should explicitly ask the facility about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the costly insurance claims cycle. While the facility's Medicare benchmark rate is $3.17, commercial rates are often higher due to contract dynamics; however, the cash price here remains the most transparent baseline for comparison. Always confirm whether your specific insurance plan has met its deductible before assuming the negotiated rate will apply, and never sign away your rights to dispute out-of-network ancillary services without fully understanding the terms.