Urinalysis (automated, with microscopy)
Facility: Wichita County Health Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $23
- Cash Discount Price: $20
- vs. Medicare Baseline: 7.26x 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 726% of the Medicare baseline (a markup of 626%). 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 |
|---|---|---|
| Medicaid / KanCare | $21 | 662% |
| UnitedHealthcare | $25 | 789% |
Consumer Guidance & Cost Commentary
For the automated urinalysis with microscopy at Wichita County Health Center in Leoti, Kansas, the facility's cash price of $20.00 is lower than the state average of $21.00, making it a cost-effective option for patients paying out-of-pocket. While the facility's negotiated rate for UnitedHealthcare is $25.00, which exceeds the cash price, patients with high-deductible plans may find it beneficial to pay the cash rate directly, as the insurance negotiated amount is higher than the self-pay fee. It is important to note that the facility is a government-owned Critical Access Hospital, and while the cash price is competitive, patients should verify if their specific insurance plan has a lower allowed amount before scheduling to ensure they are not overpaying relative to their coverage.
The facility's negotiated rate of $23.00 sits between the cash price and the UnitedHealthcare allowed amount, reflecting the administrative costs and contract dynamics typical of in-network care. Although the facility's negotiated rate is higher than the Medicare benchmark of $3.17, which indicates a significant markup, the cash price remains the most transparent and lowest cost option at $20.00. Patients are encouraged to contact the billing department directly to inquire about "prompt-pay" discounts, which can further reduce the final balance if paid in full upfront, and to request an itemized bill to ensure no errors or unbundled charges are included in the final invoice.