Urinalysis (automated, with microscopy)
Facility: Grisell Memorial Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $40
- Cash Discount Price: $55
- vs. Medicare Baseline: 12.62x 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 1262% of the Medicare baseline (a markup of 1162%). 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 |
|---|---|---|
| UnitedHealthcare | $1 - $52 | 32% |
| Blue Cross Blue Shield | $9 | 284% |
| Humana | $46 - $70 | 1451% |
| Medicaid / KanCare | $46 - $70 | 1451% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, representing an automated urinalysis with microscopy, Grisell Memorial Hospital in Ransom, Kansas, lists a cash median price of $55.00, which is notably lower than the facility's negotiated rates of $49.00 and the state average of $40.00. This pricing structure highlights a common billing dynamic where cash payments can be more cost-effective than insurance claims, particularly for patients with high deductibles or those without in-network coverage. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should verify their specific plan details, as commercial payers like UnitedHealthcare, Blue Cross Blue Shield, and Humana have negotiated rates ranging from $1 to $70 depending on the specific plan, which often exceeds the cash price.
To avoid unexpected costs, consumers should proactively request a prompt-pay discount or self-pay rate before scheduling any services, as these upfront discounts can bypass the administrative overhead associated with insurance claims processing. If a patient receives a bill that appears to include charges beyond the negotiated or cash rates, they should request a full itemized audit to identify potential errors, such as unbundled codes or services not rendered, which are common in hospital billing. It is also important to understand that while the No Surprises Act protects patients from balance billing for out-of-network emergency services at in-network facilities, patients must still carefully review their itemized statements to ensure no unexpected ancillary charges have been applied.