Urinalysis (automated, with microscopy)
Facility: Mercy Hospital Columbus
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $50
- Cash Discount Price: $45
- vs. Medicare Baseline: 15.77x 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 1577% of the Medicare baseline (a markup of 1477%). 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 |
|---|---|---|
| Globalhealth Contracted [320145] | $3 | 95% |
| UnitedHealthcare | $3 - $57 | 95% |
| Medicare (plans) | $3 - $52 | 95% |
| Medicaid / KanCare | $3 - $50 | 95% |
| Humana | $3 - $66 | 95% |
| Blue Cross Blue Shield | $3 - $50 | 95% |
| Insurance System Inc Contracted [320465] | $30 | 946% |
| Health Systems Inc Contracted [320174] | $30 | 946% |
| Administrative Payor Contracted [320005] | $31 | 978% |
| Cross Timbers Hospice [20098] | $50 | 1577% |
| Dept Of Veteran Affairs Contracted [320106] | $50 | 1577% |
| Provider Partners Health Plans Contracted [320450] | $50 | 1577% |
| Aetna | $50 - $62 | 1577% |
| Medical Associates Health Contracted [320444] | $50 | 1577% |
| Elara Caring Aspire Hospice [20433] | $50 | 1577% |
| Halo Hcr Inc Hospice [20432] | $50 | 1577% |
| Tricare | $50 | 1577% |
| Cigna | $50 | 1577% |
| Ambetter / Centene | $50 | 1577% |
| Halo Hcr Inc Hospice Contracted [320432] | $50 | 1577% |
| Kindful Hospice [20434] | $50 | 1577% |
| Kindful Hospice Contracted [320434] | $50 | 1577% |
| Mercy Hospice Okc [20252] | $50 | 1577% |
| Qual Choice Contracted [320325] | $50 | 1577% |
| Mercy Mgd Behavioral Health Contracted [320259] | $50 | 1577% |
| Pace Of The Ozarks Contracted [320518] | $50 | 1577% |
| Home State Health Plan Contracted [320187] | $50 | 1577% |
| Cherokee Nation Health Serv Contracted [320066] | $50 | 1577% |
| Novasys Contracted [320285] | $50 | 1577% |
| Indian Health Service Contracted [320198] | $50 | 1577% |
| Centurion Of Missouri [20459] | $50 | 1577% |
| Healthscope Contracted [320182] | $53 | 1672% |
| Workers Comp [20426] | $55 - $59 | 1735% |
| United Medical Resources Contracted [320454] | $57 - $66 | 1798% |
| Medica Contracted [320239] | $62 | 1956% |
| First Health Contracted [320128] | $62 | 1956% |
| Preferred Health Plan Contracted [320522] | $62 | 1956% |
| American Healthcare Alliance Contracted [320020] | $62 | 1956% |
| Healthlink Contracted [320179] | $62 - $66 | 1956% |
| Usa Managed Care Org Contracted [320429] | $62 | 1956% |
| Federal Medical Center Contracted [320127] | $62 | 1956% |
| Mercy Benefit Admin Contracted [320251] | $62 - $66 | 1956% |
| Imagine 360 Contracted [320494] | $66 | 2082% |
| Ebms Contracted [320493] | $66 | 2082% |
| 90 Degree Benefits Contracted [320436] | $66 | 2082% |
| Ppo Plus Contracted [320310] | $66 | 2082% |
| Yuzu Health Contracted [320521] | $66 | 2082% |
| Benefit Management Contracted [320052] | $66 | 2082% |
| Point C Contracted [320238] | $66 | 2082% |
| Private Health Care Systems Contracted [320320] | $66 | 2082% |
| Aither Health Contracted [320449] | $66 | 2082% |
| Show-Me Health Administrators Contracted [320483] | $66 | 2082% |
| Reflect Health Contracted [320492] | $66 | 2082% |
| Auxiant Contracted [320462] | $66 | 2082% |
| Edison Health Solutions Contracted [320502] | $66 | 2082% |
Consumer Guidance & Cost Commentary
For this urinalysis procedure at Mercy Hospital Columbus, the facility's cash price of $45.00 is lower than the state average of $69.00, offering a potential savings for patients paying out-of-pocket. However, commercial insurance negotiated rates average $50.00, which is slightly higher than the cash price but significantly lower than the gross charge. Because commercial rates often include administrative overhead and do not reflect the true cost of care, patients with high-deductible plans may find paying the cash price directly more economical than relying on insurance, provided they qualify for the facility's self-pay or prompt-pay discounts.
The facility's negotiated rates range from $3.17 for Medicare to $66.00 for some commercial payers, with a median paid amount of $74.00 across all payers. While the Medicare rate of $3.17 serves as a benchmark for the true cost of delivery, commercial rates can vary widely depending on the specific plan and contract. Patients should verify their specific allowed amounts before scheduling, as in-network status does not guarantee the lowest possible price. To avoid unexpected costs, individuals should request an itemized bill to review all CPT codes and ensure no unbundled charges or services not rendered are included, and they should explicitly ask about prompt-pay discounts before check-in to secure immediate cash flow benefits.