Urinalysis (automated, with microscopy)
Facility: Kearny County Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $55
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 17.35x 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 1735% of the Medicare baseline (a markup of 1635%). 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 |
|---|---|---|
| Community Care Health Plan Of | $55 | 1735% |
| Aetna | $55 | 1735% |
| UnitedHealthcare | $55 | 1735% |
| Meritain Health | $55 | 1735% |
| Humana | $55 | 1735% |
| Blue Cross Blue Shield | $55 | 1735% |
| Kansas Solutions | $55 | 1735% |
| Wps Gha - Mac J5 Part A | $55 | 1735% |
| Luminare Health | $55 | 1735% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, representing an automated urinalysis with microscopy, the negotiated rates across nine major payers in Kearny County Hospital are consistently $55.00, matching the facility's median negotiated rate exactly. This uniformity suggests a standardized contract structure among insurers like UnitedHealthcare, Aetna, and Community Care Health Plan. However, it is important to note that this negotiated amount is significantly higher than the Medicare benchmark of $3.17, reflecting the typical administrative markup inherent in commercial insurance contracts. For patients with high-deductible plans who have not yet met their out-of-pocket threshold, paying the cash price could result in substantial savings, as the cash median is not listed but is often lower than the $55.00 insurance allowed amount.
While the facility is a Critical Access Hospital in Lakin, KS, with government-local ownership, the data indicates that the cash price is not explicitly listed in this report. Patients should proactively contact the hospital billing department to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final cost by 20% to 50% if settled upfront. Additionally, if you have received a bill from this facility, you should request a full itemized CPT-coded statement rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or services not rendered. If you encounter a balance bill for out-of-network ancillary services, you may be protected under the No Surprises Act, which prohibits providers from billing you for the difference between their chargemaster rate and your insurance's allowed amount for emergency or non-emergency care at in