Urinalysis (automated, with microscopy)
Facility: Rawlins County Health Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $30
- Cash Discount Price: $30
- vs. Medicare Baseline: 9.46x 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 946% of the Medicare baseline (a markup of 846%). 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 | $10 | 315% |
| UnitedHealthcare | $30 | 946% |
Consumer Guidance & Cost Commentary
For the Urinalysis (automated, with microscopy) procedure at Rawlins County Health Center in Atwood, Kansas, the cash price is $30.00, which is $5.00 lower than the facility's gross charge of $35.00. This cash rate aligns exactly with the state of Kansas average, offering a predictable cost for patients paying out-of-pocket. While the facility's negotiated rates with Blue Cross Blue Shield and UnitedHealthcare are also $30.00, commercial insurance payments often exceed cash prices due to administrative overhead and contract structures. If you have a high-deductible plan, paying the $30.00 cash price upfront may be more cost-effective than relying on insurance, which could result in higher allowed amounts after your deductible is met.
To ensure you are receiving fair pricing, it is important to understand that Medicare rates serve as a reliable benchmark for evaluating hospital costs. For this specific code, the Medicare amount is $3.17, meaning the facility's cash price is approximately 9.5 times the Medicare rate. This significant markup reflects the complexity of commercial billing and the inclusion of administrative fees that are not present in federal reimbursement. If you receive a summary bill, request a full itemized statement to verify that no unbundled charges or services not rendered are included, as these errors can inflate your total debt. Additionally, ask the billing department about prompt-pay discounts, which can further reduce your final out-of-pocket expense if you settle the account quickly.