Urinalysis (automated, with microscopy)
Facility: Ashland Health Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $20
- Cash Discount Price: $22
- vs. Medicare Baseline: 6.31x 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 631% of the Medicare baseline (a markup of 531%). 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 | $5 - $13 | 158% |
| Compalliance-All Plans | $13 - $32 | 410% |
| Health Partners Of Kansas-All Plans | $14 - $34 | 442% |
| Healthy Blue Mcr Adv - All Other Plans | $16 - $40 | 505% |
| Aetna | $16 - $40 | 505% |
| Medicaid / KanCare | $16 - $40 | 505% |
| Medica Mcare - All Plans | $16 - $40 | 505% |
| UnitedHealthcare | $16 - $40 | 505% |
| Multiplan-All Plans | $16 - $39 | 505% |
| Health Choice-All Plans | $16 - $40 | 505% |
| Medicare (plans) | $16 - $40 | 505% |
| Providers Care (Wppa)-All Plans | $24 - $60 | 757% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Ashland Health Center in Ashland, KS, lists a cash median price of $22.00 and a median negotiated rate of $20.00. When compared to the Medicare benchmark of $3.17, the facility's cash price represents a markup of approximately 693%, while the negotiated rate is roughly 631% of the Medicare rate. It is important to note that while commercial negotiated rates are often higher than cash prices due to administrative overhead and contract structures, paying cash directly can sometimes result in lower out-of-pocket costs for patients with high-deductible plans, provided the insurance allowed amount exceeds the cash price. Patients should verify their specific plan's deductible status and allowed amounts before scheduling, as paying the full negotiated rate without meeting a deductible can lead to significant unexpected expenses.
Facility pricing transparency also reveals that the cash median of $22.00 is higher than the state average for this service, though specific county averages were not provided in the available data. The facility, a Critical Access Hospital owned by a voluntary non-profit, offers a prompt-pay discount mechanism that can reduce costs if patients pay upfront, bypassing the administrative costs associated with insurance claims processing. To ensure you receive the best possible rate, it is recommended to request a self-pay classification and prompt-pay discount prior to check-in, and to obtain a full itemized bill rather than accepting a summary invoice. If you receive a balance bill for services rendered at this in-network facility, you may be entitled to protections under the No Surprises Act, and you should request a formal written audit dispute if any charges